摘要
目的探讨前腹壁悬吊(免气腹)腹腔镜辅助下婴儿先天性巨结肠(HD)根治术的特点。方法用气囊导尿管充生理盐水1.5～2.0ml前腹壁悬吊行13例前腹壁悬吊腹腔镜辅助下婴儿HD根治术,比较了13例免气腹组和17例CO2气腹组手术中血流动力学参数和量化手术效果参数。结果气腹组在术中因腹内压增高可以致血流动力学参数平均动脉压(MAP)、PaCO2、心脏指数(CI)、HCO3-发生显著性变化,前腹壁悬吊组则保持稳定的参数值。两组在手术效果上差异无统计学意义。结论前腹壁悬吊腹腔镜辅助下HD根治术其前腹壁提拉装置构思新颖,实用性强,具有安全性,可行性,大大减少了由于腹内高压对血流动力学参数的影响,该手术方法值得在临床上推广。
Objective To investigate the feasibility of gasless laparoscopy-assisted surgery as an alternative method for neonate Hirschsprung＇ disease （HD）. Methods From Jan. 2003 to April 2004, 13 patients with HI） underwent gasless laparoscopy-assisted surgery. The operative field was exposed with a subcutaneous wire lifting system having an air pocket urinary catheter. In control group, 17 patients received CO2 pneumoperitoneum laparoscopy-assisted surgery. The cardiopulmonary responses of the patients and the effect of operations were monitored continuously during the operation between gasless vs CO2 pneumoperitoneum laparoscopy-assisted surgery. Results In the gaseous group, statistically significant changes were detected in MAP, PaCO2, CI and HCO3^- values after insufflation as compared to the values before or over pneumoperitoneum. In the gasless group, no significant difference in cardiopulmonary parameters and effects of operation were found. Conclusion Gasless laparoseopy-assisted HD surgery has little effect on the hemodynamic parameters of patients and is technically feasible, which may be an alternative means for the performance of minimal-access surgery for neonate HD.
出处
《中华实验外科杂志》
CAS
CSCD
北大核心
2005年第8期1013-1015,共3页
Chinese Journal of Experimental Surgery
基金
国家自然科学基金资助项目(30371397)
湖北省自然科学基金资助项目(2003ABA151)
