腹腔镜粘连松解术治疗小儿阑尾切除术后肠粘连的疗效观察

Clinical observation of laparoscopic adhesiolysis on intestinal adhesion after appendectomy in children

目的观察腹腔镜粘连松解术治疗小儿阑尾切除术后肠粘连的临床疗效。方法选择2015年6月—2017年6月住院治疗的阑尾切除术后并发肠粘连患儿60例,采用随机数字表法分为对照组和观察组,每组各30例。对照组行开腹肠粘连松解术,观察组行腹腔镜粘连松解术;观察2组患儿的围术期疗效指标、术后并发症和术后6个月后生活质量评分。结果观察组手术时间、术中出血量、胃肠功能恢复时间、腹痛消失时间及住院时间均明显少于对照组(P<0.05),并发症发生率亦明显低于对照组(5.00%对20.00%,P<0.05);术后6个月患儿的躯体活动、心理情绪、社交家庭及物质生活各维度评分则明显高于对照组(P<0.05)。结论腹腔镜粘连松解术治疗阑尾切除术后肠粘连疗效显著,创伤小,恢复快,并发症少,利于改善患儿术后生活质量,值得推广。

Objective To observe the clinical effect of laparoscopic adhesiolysis for intestinal adhesion in children after appendectomy. Methods A total of 60 children with intestinal adhesion who underwent appendectomy in Kanghua Hospital from June 2015 to June 2017 were selected and divided into a control group and an observation group by random number table method,with 30 cases in each group. The control group underwent open laparoscopic adhesion dissection,while the observation group received laparoscopic adhesiolysis. The perioperative effect indices,postoperative complications,and quality of life scores of the two groups were observed. Results The operation time,intraoperative blood loss, gastrointestinal function recovery time, abdominal pain disappearing time, and hospital stay of the observation group were significantly lower than those of the control group（ P〈0. 05）; the complication rate of the observation group was also significantly lower than that of the control group（ 5. 00 % vs. 20. 00%,P〈0. 05）. The scores of physical,emotional,social/family,and functional well-being at 6 months post operation of the observation group were significantly higher than those of the control group（ P〈0. 05）. Conclusion Laparoscopic adhesiolysis has an excellent clinical effect on intestinal adhesions in children after appendectomy,with little trauma,quick recovery,and less postoperative complications,which improves quality of life and is worth promoting.