腹腔镜离断性肾盂成形术治疗肾盂输尿管连接部狭窄患儿的疗效分析

Efficacy and safety of laparoscopic pyeloplasty in the treatment of ureteropelvic junction stenosis

目的探究肾盂输尿管连接部狭窄患儿采用腹腔镜离断性肾盂成形术治疗的效果。方法选取江门市人民医院及中山大学附属第一医院2018年1月~2019年3月肾盂输尿管连接部狭窄患儿62例,根据手术方案不同分组,各31例。对照组行开放手术,观察组行腹腔镜离断性肾盂成形术。对比两组手术指标、并发症、肾积水复发情况、创伤指标如白介素-6(IL-6)、C反应蛋白(CRP)变化。结果观察组术中出血量较对照组低,手术、肠道恢复、住院时间较对照组短(P<0.05);观察组并发症发生率3.23%较对照组25.81%低(P<0.05);术后1 d、术后2 d观察组血清IL-6、CRP水平较对照组低(P<0.05);两组肾积水复发率无显著差异(P>0.05)。结论腹腔镜离断性肾盂成形术治疗小儿肾盂输尿管连接部狭窄,具有创伤小、术后恢复快等优势,且安全性较高。

Objective To investigate the effect of laparoscopic ureteroplasty in children with uretero-pelvic junction stenosis.Methods 62 children with ureteropelvic junction stenosis were selected from Jiangmen People′s Hospital and the First Affiliated Hospital of Sun Yat-sen University from January 2018 to March 2019.According to the surgical plan,31 cases were included.The control group underwent open surgery,and the observation group underwent laparoscopic pyeloplasty.The surgical indexes,com plications,recurrence rate of hydronephrosis,and interleukin-6(IL-6),C-reactive protein(CRP)were compared between the two groups.Results The intraoperative blood loss was lower in the observation group than in the control group.The operation time,intestinal recovery and hospitalization time were shorter than the control group(P<0.05).The incidence of complications in the observation group was 3.23%lower than that in the control group(P<0.05).The levels of serum IL-6 and CRP in the observa tion group were lower than those in the control group 1 day after operation and 2 days after operation(P<0.05).There was no significant difference in the recurrence rate of hydronephrosis between the two groups(P>0.05).Conclusion Laparoscopic pyeloplasty for the treatment of ureteropelvic junction stenosis in children has the advantages of less trauma and quicker postoperative recovery,and it is safer.