腹腔镜与传统开腹手术治疗小儿胃十二指肠穿孔的临床疗效比较

Comparison of clinical efficacy of laparoscopic surgery and traditional laparotomy in the treatment of children with gastroduodenal perforation

目的比较腹腔镜与传统开腹手术治疗小儿胃十二指肠穿孔的临床效果,探讨腹腔镜治疗的优势。方法将我院收治的50例胃十二指肠穿孔患儿按照随机数字表法分为观察组和对照组各25例,观察组采用腹腔镜治疗,对照组采用传统开腹治疗,比较两组患儿治疗及手术过程中的各项指标,术后视觉模拟评分(VAS)、并发症发生情况及患儿家属满意度。结果两组手术时间差异无统计学意义(P>0.05)。术后2h和4h两组患儿视觉模拟评分(VAS)差异无统计学意义(P>0.05),术后12h和24h观察组患儿VAS评分低于对照组(P<0.05)。观察组住院时间、术后肛门首次排气时间、手术中出血量均低于对照组,术后并发症发生率亦低于对照组,患儿家属满意度高于对照组,差异均有统计学意义(P<0.05)。结论与传统开腹手术比较,腹腔镜手术治疗小儿胃十二指肠穿孔有利于患儿术后恢复,降低了手术风险,术后并发症少,且伤口小,可减轻小儿疼痛感,住院时间也相对减少,更符合现在的临床治疗。

Objective To explore the effect and feasibility of laparoscopic surgery on the gastroduodenal perforation in children.Methods Fifty sick children with gastroduodenal perforation treated in our hospital were divided into observation group and control group according to surgical method,25 in each group.The observation group was treated with laparoscopic surgery while the control group was treated with open-abdominal surgery.The various indicators during operation,the postoperative visual analogue score（VAS）,postoperative complications and the satisfaction of the family were compared between the two groups.Results There was no difference in the operation time between the two groups（P〉0.05）.There was no significant difference in visual analogue score（VAS）between groups of 2 hand 4 hafter operation（P〉0.05）.The VAS score of children in 12 hand24 hobservation group was lower than that of the control group（P〈0.05）.In the observation group,the hospitalization time,the first exhaust time of the anus after operation,and the amount of bleeding during the operation were lower when compared to the control group.The postoperative complications was lower in the observation group than that in the control group.The family satisfaction of the children was higher than that of the control group（P〈0.05）.Conclusion Laparoscopic surgical treatment of pediatric patients with gastroduodenal perforation is conducive to recovery for patients,reduce the risk of surgical and postoperative complications,lighten the pediatric pain and trauma and shorten the hospital stay.Therefore,it is more in line with the current clinical treatment.