腹腔镜与传统开腹手术治疗小儿消化道磁性异物的对比研究

Comparative study between laparoscopy and laparotomy operation in the treatment of multiple magnetic foreign body ingestion in children

目的对比腹腔镜与传统开腹手术治疗小儿胃肠道磁性异物的优劣势。方法选取2011年2月~2021年7月本院收治的误服磁性异物患儿共38例,对其回顾性分析并分为两组,腹腔镜组(18例)和开腹组(20例),统计其年龄、性别、误服磁珠个数、穿孔数目及肠穿孔部位;对手术时间、失血量、术后疼痛评分、开始下床活动时间、禁食时间、并发症及住院时间进行分析。结果腹腔镜组手术时间为(125.6±34.0)分钟、术中失血量(5.9±1.9)ml,术后并发症为0例,开腹组分别为(128.0±33.0)分钟、(6.9±2.7)ml、2例,两组比较差异无统计学意义(P>0.05);腹腔镜组术后疼痛评分为(3.2±0.5)分、开始下床活动时间(57.4±14.7)小时、禁食时间(3.8±0.5)天、住院时间(6.5±0.7)天,开腹组分别为(4.4±0.5)分、(83.9±18.9)小时、(5.7±1.9)天、(8.9±2.2)天,两组比较差异有统计学意义(P<0.05)。结论在治疗胃肠道磁性异物时腹腔镜手术较传统开腹手术具有相同的安全性,且在术后康复方面优势明显。

Objective To detect the superiority of laparoscopic operation over laparotomy in the treatment of multiple magnetic foreign body ingestion in children.Methods A total of 38 children with multiple magnetic foreign bodies ingestion from February 2011 to July 2021 were retrospectively analyzed and divided into two groups,laparoscopic group(18 cases)and laparotomy group(20 cases).The information including age,gender,and number of magnetic beads,number of perforations and location of intestinal perforations were counted;additional information containing the operative time,blood loss,postoperative pain score,time to move freely,fasting time,complications and hospital stay was analyzed.Results In the laparoscopic group,the operative time was(125.6±34.0)minutes,the intraoperative blood loss was(5.9±1.9)ml,and there were 0 cases of postoperative complications.The data of the laparotomy group were(128.0±33.0)minutes,(6.9±2.7)ml、2 cases,there was no significant difference between the two groups(P>0.05).The postoperative pain score in the laparoscopy group was(3.2±0.5)points,the time to move freely was(57.4±14.7)hours,and the fasting time(3.8±0.5)days,hospital stay(6.5±0.7)days,the laparotomy group were(4.4±0.5)points,(83.9±18.9)hours,(5.7±1.9)days,(8.9±2.2)days,there was significant difference between the two groups(P<0.05).Conclusion Laparoscopic surgery has certain advantages of enhancing recovery and releasing pain over laparotomy operation in the treatment of multiple magnetic foreign body ingestion in children.