小儿Meckel憩室患者不同分型及单孔腹腔镜手术治疗分析

Analysis of different typing and single hole laparoscopic surgery for Meckel diverticulum in children

目的 :研究小儿Meckel憩室不同分型状况及单孔腹腔镜手术治疗的临床疗效。方法 :选取2012年3月~2016年3月接诊的68例Meckel憩室患儿进行研究,按照患儿腹腔镜下憩室形态状况,分为单纯型(n=38)和复杂型(n=30)两种分型。两种分型患儿均采用单孔腹腔镜手术对患儿进行治疗。比较分析两种分型患儿手术指标,不同分型Meckel憩室患儿病理状况及术后并发症状况。结果 :单纯型Meckel憩室患儿的术中出血量明显少于复杂型患儿,手术时间、术后进食时间、术后下床活动时间及住院时间明显短于复杂型患儿,两种分型比较有统计学意义。单纯型Meckel憩室患儿肿胀、炎性细胞浸润,溃疡形成的病理类型发生率(0)明显低于复杂型患儿(36.67%),两种分型比较有显著性差异。单纯型术后感染(5.26%)、小肠梗阻(5.26%)及肠粘连(5.26%)的发生率明显低于复杂型患儿(23.33%、23.33%、26.67%),两种分型比较有统计学意义。结论 :单孔腹腔镜手术治疗Meckel憩室,效果良好,单纯型Meckel憩室患儿的手术指标、病理状况及并发症均优于复杂型。

Objective To study the clinical classification of different types of Meckel diverticulum and the effect of single hole laparoscopic surgery in children.Methods 68 children with Meckel diverticulum from March 2012 to March 2016 were studied.According to the shape of the diverticulum,the children were divided into two types:simple type(n=38)and complex type(n=30).Two types of children were treated with single hole laparoscopic surgery for the treatment of children.The operation index,status of different types of Meckel patients and postoperative pathological conditions of diverticulum of two types of patients were compared and analyzed.Results The children with simple type Meckel diverticulum bleeding was significantly less than the complex patients,operation time,postoperative feeding time,postoperative ambulation time and hospitalization time were significantly shorter in complex with two types were statistically significant.The diverticulum swelling,inflammatory cell infiltration,the incidence of pathological types of ulcer formation(0)of the simple type Meckel with were significantly lower than that of children with complex type(36.67%),two genotypes had significant difference.The postoperative infection(5.26%),small bowel obstruction(5.26%)and intestinal adhesion(5.26%)of the simple type were significantly lower than that of children with complex type(23.33%,23.33%,26.67%),two genotypes were statistically significant.Conclusion Single hole laparoscopic surgery for the treatment of Meckel diverticulum is effective,and the surgical indexes,pathological conditions and complications of children with simple Meckel diverticulum are better than those of complex type.