腹腔镜下治疗小儿小肠出血18例效果观察

Laparoscopic treatment of small intestine hemorrhage in children:report of 18 cases

目的:探讨腹腔镜诊断和治疗儿童下消化道出血的临床价值。方法:对18例术前不明原因下消化道出血,怀疑小肠病变的患儿行腹腔镜探查术,15例确诊后14例经右下腹延伸小切口,提出肠管在腹腔外手术,1例免于手术;3例病因不明。结果:14例患儿均无中转开腹手术,手术时间40～90min,平均75min。术后5～10d出院,无任何并发症。结论:小儿腹腔镜具有创伤小、安全可靠、诊断率高等特点,可替代剖腹探查术,适用于不明原因的儿童下消化道出血病例,尤其怀疑小肠出血。

Objective：To explore the value of laparoscopic diagnosis and treatment for small intestine hemorrhage in children.Methods：Laparoscopic exploration was performed in 18 children with unexplained small intestine hemorrhage.15 patients were correctly diagnosed by laparoscopy,incisions in 14 cases were extended to take out the corresponding intestine for resection.1 case with no operation.3 cases were agnogenic.Results：No conversions to laparotomy were required in all the 14 children.The operation time lasted 40～ 90 min（mean 75 min）.The children were discharged at postoperative 5～10 d without complications.Conclusion：Laparoscopic diagnosis and treatment have many advantages such as decreasing injury,safety and higher rate of diagnosis,which may substitute exploratory laparotomy and be effective in children with unexplained lower digestive tract hemorrhage,especially be effective in children with suspected small intestine hemorrhage.