观察经脐部弧形切口治疗先天性肥厚性幽门狭窄的临床效果

Observation of clinical effect of transumbilical curved incision in the treatment of congenital hypertrophic pyloric stenosis

目的比较经脐部弧形切口与右上腹横切口对先天性肥厚性幽门狭窄的治疗效果。方法 74例先天性肥厚性幽门狭窄患儿,按治疗方法不同分为观察组(36例)和对照组(38例)。两组患儿均施行Fredet-Ramstedt幽门环肌切开术,观察组经脐部弧形切口手术治疗,对照组经右上腹横切口手术治疗,对两组患儿临床疗效进行对比。结果两组手术时间、黏膜破裂、浆膜撕裂、切口感染比较差异无统计学意义(P>0.05)。两组患儿均痊愈出院,术后无死亡或严重并发症。术后随访6~12个月,观察组瘢痕愈合良好患者94.44%(34/36),明显优于对照组的73.68%(28/38),差异有统计学意义(P<0.05)。结论经脐部弧形切口行幽门环肌切开术,切口愈合好,而且瘢痕不明显,美容效果良好,值得临床推广使用。

Objective To compare curative effects by transumbilical curved incision and right epigastric transverse incision in the treatment of congenital hypertrophic pyloric stenosis. Methods A total of 74 children patients with congenital hypertrophic pyloric stenosis were divided by different treatment methods into observation group（36 cases） and control group（38 cases）, and both groups received Fredet-Ramstedt pyloromyotomy. The observation group received transumbilical curved incision for operation, and the control group received right epigastric transverse incision for operation. Clinical effects were compared between the two groups. Results There was no statistically significant difference of operation time, mucous membrane rupture, serosa laceration and incision infection between the two groups（P〈0.05）. Children patients in both groups were cured and discharged, without any postoperative death or severe complications. Postoperative follow-up for 6~12 months showed obviously better scar healing rate as 94.44%（34/36） in the observation group than 73.68%（28/38） in the control group, and their difference had statistical significance（P〈0.05）. Conclusion Pyloromyotomy through transumbilical curved incision provides excellent incision healing, with unapparent scar and good cosmetic result. This method is worth clinical promotion and application.