[1]曹振杰,杜俊鹏,黄泓玮,等.腹腔镜改良Soave术治疗小儿巨结肠的临床疗效观察[J].郑州大学学报(医学版),2018,(03):392-395.[doi:10.13705/j.issn.1671-6825.2017.08.071]
 CAO Zhenjie,DU Junpeng,HUANG Hongwei,et al.Cinical efficacy of laparoscope Soave operation in treatment of children with hirschsprung[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2018,(03):392-395.[doi:10.13705/j.issn.1671-6825.2017.08.071]
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腹腔镜改良Soave术治疗小儿巨结肠的临床疗效观察()
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《郑州大学学报(医学版)》[ISSN:1671-6825/CN:41-1340/R]

卷:
期数:
2018年03期
页码:
392-395
栏目:
应用研究
出版日期:
2018-03-20

文章信息/Info

Title:
Cinical efficacy of laparoscope Soave operation in treatment of children with hirschsprung
作者:
曹振杰杜俊鹏黄泓玮孙雪花陈 玄陈 琦
郑州大学第三附属医院小儿外科 郑州 450052
Author(s):
CAO Zhenjie DU Junpeng HUANG Hongwei SUN Xuehua CHEN Xuan CHEN Qi
Department of Pediatric Surgery, the Third Affiliated Hospital, Zhengzhou University, Zhengzhou 450052
关键词:
小儿巨结肠 腹腔镜 Soave术 疗效 并发症
Keywords:
children with hirschsprung laparoscope Soave operation efficacy complication
分类号:
R726
DOI:
10.13705/j.issn.1671-6825.2017.08.071
摘要:
目的:探讨腹腔镜改良Soave术治疗小儿巨结肠的临床疗效。方法:回顾性分析腹腔镜改良Soave术治疗的150例巨结肠患儿手术情况,术后均随访1 a,评估并比较患儿术后6、12个月排便功能,检测并比较手术前后直肠肛管压力变化,统计所有患儿术后相关并发症发生情况。结果:147例患儿手术顺利完成,手术成功率98.0%; 剩余3例因术中腹腔粘连严重转为开腹手术。术后6个月及12个月患儿排便功能优良率分别为72.8%及93.2%,且术后12个月较术后6个月升高(P<0.001); 与术前比较,术后6个月患儿直肠静息压力及肛管静息压力均降低(P<0.001),肛管高压区长度缩短(P<0.001); 患儿腹腔镜Soave术后小肠结肠炎、便秘、大便失禁及污粪等并发症的发生率分别为2.7%、3.4%、4.1%及3.4%,经对症治疗后均好转。结论:腹腔镜改良Soave术可有效改善巨结肠患儿术后排便功能,恢复其控便能力,并有效减少术后并发症的发生,具有较高的安全性。
Abstract:
Aim: To explore the clinical efficacy of laparoscope Soave operation in the treatment of children with hirschsprung.Methods: A total of 150 children with hirschsprung who accepted the laparoscope Soave operation in our hospital, and followed-up for 1 year post-operation were enrolled in the study. The defecation function 6 and 12 months post-operation, the change of rectal pressure pre-operation and post-operation, and the occurence of related complications post-operation were recorded or evaluated.Results: The operation of 147 children completed successfully, the achievement ratio of operation was 98.0%; the remaining 3 cases converted to open operation due to the serious intraoperative intraperitoneal adhesion. The distingushed achiever ratio of defecation function of the patients 6 and 12 months post-operation were 72.8% and 93.2%, respectively, and the ratio in the 12 months post-operation was higher than that in the 6 months post-operation(P<0.001); compared with pre-operation, the rectal resting pressure and anal resting pressure decreased significantly 6 months post-operation(P<0.001), the anal canal high length shortened significantly(P<0.001); the occurrence rates of enterocolitis, constipation, fecal incontinence and fouling dung of the patients after operation were 2.7%, 3.4%, 4.1% and 3.4%, which were improving after symptomatic treatment.Conclusion: Laparoscope Soave operation can improve the defecation function of children with hirschsprung effectively, restore the control ability and reduce the occurrence of related complications post-operation with high safety.

参考文献/References:

[1] 张清君, 苟丽, 张素芳. 小儿先天性巨结肠经肛门根治120例分析[J]. 郑州大学学报(医学版), 2009, 44(2): 459
[2] ZHU T, FENG J, ZHANG W, et al. Subtotal colectomy with a single-incision laparoscopic surgery technique in children with long-segment Hirschsprung disease and allied disorders[J]. Pediatr Surg Int, 2013, 29(2):197
[3] 王海阳.腹腔镜下行改良Soave术治疗新生儿先天性巨结肠的疗效观察[J].临床医学工程, 2015, 22(5):542
[4] 马永利, 张传龙, 吴小亚,等. 新生儿先天性巨结肠的早期诊断与治疗[J]. 临床医学, 2007, 27(2):33
[5] 邵曹慧, 张宏伟, 刘丰丽,等. 腹腔镜手术治疗小儿先天性巨结肠的临床分析[J]. 腹腔镜外科杂志, 2014, 19(11):855
[6] 王世平, 段卫星. 腹腔镜辅助下经肛门改良Soave术治疗常见型先天性巨结肠的疗效[J]. 中华实用儿科临床杂志, 2017, 32(4):316
[7] 张建军, 张宏伟, 刘丰丽,等. 腹腔镜下改良Soave's法治疗新生儿先天性巨结肠术后近期功能评价[J]. 中华小儿外科杂志, 2013, 34(6):416
[8] 石群峰, 李新宁, 罗树友. 腹腔镜辅助Soave根治术治疗新生儿先天性巨结肠:附73例报告[J]. 腹腔镜外科杂志, 2010, 15(10):757
[9] 金祝. 经肛门改良Soave Ⅰ期巨结肠根治术后直肠肛门测压及排便功能研究[D]. 遵义: 遵义医学院, 2010.
[10]刘鸿坚,杨传民,祁泳波,等.经肛门改良Soave术和经腹治疗先天性巨结肠的疗效对比研究[J].现代生物医学进展, 2011, 11(11):2135

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备注/Memo

备注/Memo:
【作者简介】陈琦,通信作者,男,1963年4月生,硕士,主任医师,研究方向:小儿消化道畸形,E-mail:chen63qi@126.com
更新日期/Last Update: 2018-05-20