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腹腔镜手术对肠旋转不良患儿术后复发及胃肠功能恢复的影响

来源:用户上传      作者:谭卓宏

   【摘要】 目的:探究腹腔镜手术对肠旋转不良患儿术后复发及胃肠功能恢复的影响。方法:选取2015年12月-2018年12月本院收治的60例肠旋转不良患儿为研究对象,依据治疗方式的不同分为对照组(开腹手术,30例)和观察组(腹腔镜手术,30例)。比较两组术后复发率、肠鸣音恢复时间、排气时间、排便时间、术前及术后的餐前及餐后胃肠激素水平。结果:两组术后复发率比较,差异无统计学意义(P>0.05);观察组肠鸣音恢复时间、排气时间、排便时间均短于对照组,差异均有统计学意义(P<0.05);术前,两组餐前及餐后胃肠激素水平比较,差异均无统计学意义(P>0.05),术后,观察组餐前及餐后胃肠激素水平均高于对照组,差异均有统计学意义(P<0.05)。结论:腹腔镜手术对肠旋转不良患儿术后复发及胃肠功能恢复的影响相对较好,在本类患儿中的应用价值相对较高。
   【关键词】 腹腔镜手术 肠旋转不良 术后复发 胃肠功能恢复
   [Abstract] Objective: To observe and investigate the influence of laparoscopic surgery for postoperative recurrence and gastrointestinal function recovery of children with malrotation of intestine. Method: A total of 60 children with malrotation of intestine from December 2015 to December 2018 were chosen as the research object,and they were divided into the control group (open surgery, 30 cases) and observation group (laparoscopic surgery, 30 cases), according to differences of treatment methods. The postoperative recurrence rates, recovery time of bowel sound, exhaust time, defecation time, pre-meal and post-meal gastrointestinal hormone levels before and after the surgery of two groups were compared. Result: The postoperative recurrence rates of two groups were compared, there was no statistically significant difference (P>0.05). The recovery time of bowel sound, exhaust time, defecation time and hospitalization time of the observation group were shorter than those of the control group, there were statistically significant differences (P<0.05). The pre-meal and post-meal gastrointestinal hormone levels of two groups before the surgery were compared, there were no statistically significant differences (P>0.05), the pre-meal and post-meal gastrointestinal hormone levels of the observation group after the surgery were higher than those of the control group, there were statistically significant differences (P<0.05). Conclusion: Laparoscopic surgery has a relatively good effect on postoperative recurrence and gastrointestinal function recovery of children with intestinal malrotation, and has a relatively high application value in this class of children.
   腸旋转不良的肠旋转运动发生障碍,在婴儿及儿童期较为常见,可导致肠梗阻等不良情况,严重威胁着患儿的生命安全,因此临床对于肠旋转不良患儿的重视程度极高,与本类患儿相关的治疗研究仍以手术为主[1]。而小儿患者的手术耐受多较差,因此手术方式的选取方面是研究重点。腹腔镜手术在肠旋转不良患儿中的应用占比不断提升,效果受肯定程度较高,但是关于腹腔镜手术对患儿术后复发及胃肠功能恢复的影响仍少见[2-3],尤其是术后复发的影响研究极为必要。故本研究笔者就本方面进行细致探究,以进一步了解腹腔镜手术在肠旋转不良患儿中的应用价值,现报道如下。
  1 资料与方法
  1.1 一般资料 选取2015年12月-2018年12月本院收治的60例肠旋转不良患儿作为研究对象。纳入标准:符合肠旋转不良的小儿;符合手术指征。排除标准:合并其他先天性疾病;呼吸窘迫及缺氧缺血;心肝肾等功能障碍;凝血功能障碍;合并感染。依据治疗方式的不同分为对照组和观察组,各30例。该研究已经伦理学委员会批准。   [7] Agrawal V,Tiwari A,Acharya H,et al.Laparoscopic ‘steering wheel’ derotation technique for midgut volvulus in children with intestinal malrotation[J].J Minim Access Surg,2019,15(3):219-223.
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  (收稿日期:2019-07-08) (本文编辑:程旭然)
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