腹腔镜手术治疗水压灌肠复位失败小儿肠套叠的临床应用

Clinical Application of Laparoscopic Surgery for Infantile Intussusception Failure Due to Hydrostatic Enema Reduction

目的探讨腹腔镜手术在治疗水压灌肠复位失败小儿肠套叠中的应用方法随机选取2015年3月—2018年5月水压灌肠复位失败的小儿肠套叠患者78例,根据研究对象采用的手术方式,分为常规开腹手术(对照组)和腹腔镜手术(实验组)两组,对比分析两组手术时长、术中出血量,随访观察术后肠粘连、肠梗阻等并发症的发生情况,肠套叠的复发情况以及术后住院天数;结果实验组手术时长、术中出血量显著低于对照组,实验组术后住院天数、肠粘连、肠梗阻和并发症的发生率均显著低于对照组,差异具有统计学意义(P<0. 05).结论腹腔镜手术治疗水压灌肠复位失败的小儿肠套叠具有手术创伤少、术后恢复快,减少患儿住院天数,术后肠粘连、肠梗阻等并发症少的优势。

Objective To explore the application of laparoscopy in the treatment of intussusception in children with failed reduction by hydraulic enema. Methods 78 children with intussusception who failed to reposition by hydraulic enema from March 2015 to May 2018 were randomly selected and divided into two groups: routine open surgery( control group) and laparoscopic surgery( experimental group) according to the operation methods adopted by the subjects. The operation duration and intraoperative bleeding volume of the two groups were compared and analyzed. The occurrence of complications such as intestinal adhesion and intestinal obstruction after operation was followed up. Recurrence of intussusception and days of hospitalization after operation were analyzed. Results The length of operation and the amount of bleeding in the experimental group were significantly lower than those in the control group. The number of days in hospital,intestinal adhesion,intestinal obstruction and complications in the experimental group were significantly lower than those in the control group( P < 0. 05).Conclusion Laparoscopic technique assisted treatment of acute intussusception in children with failed enema reduction can achieve less trauma,faster recovery after operation,less hospitalization days,fewer complications such as intestinal adhesion and intestinal obstruction after operation.