摘要
目的研究微创手术治疗小儿肝囊型包虫病的临床疗效。方法以2016年1月—2019年1月新疆医科大学第一附属医院小儿外科收治的98例肝囊型包虫病患儿为研究对象,所有患儿采用肝包虫内囊摘除术+外囊次全切术治疗,其中对照组(n=49)和观察组(n=49)分别采用传统开放术、腹腔镜下手术。对两组患儿的包虫囊肿、术中情况、术后情况、术后1个月内疼痛情况、术后24个月内并发症情况和术后24个月临床疗效进行比较。结果与对照组比较,观察组患儿手术时间增大,术中出血量、术后首次排气时间、下床时间、术后带管天数、术后住院时间均减小,住院费用和后1个月内疼痛评分优良率均升高,差异统计学有意义(P<0.05)。与对照组比较,观察组患儿胸腔积液和切口感染发生率均减小,患儿术后24个月的临床有效率升高,临床复发率降低,差异统计学有意义(P<0.05)。结论腹腔镜肝包虫内囊摘除术+外囊次全切术治疗肝囊型包虫病,能够有效减少术中出血量和术后胸腔感染的发生率,缓解术后疼痛,促进术后康复,减少术后远期并发症发生率,值得临床推广。
Objective To study the clinical efficacy of minimally invasive surgery in the treatment of cystic echinococcosis of children.Methods From January 2016 to January 2019,98 children with hepatic cystic hydatid disease admitted to the XX Department of the First Affiliated Hospital of Xinjiang Medical University were selected as the research object.All children were treated with hepatic hydatid internal cystectomy+external cyst times Total resection treatment.The control group(n=49)and the observation group(n=49)were treated with traditional open surgery and laparoscopic surgery.The hydatid cysts,intraoperative conditions,postoperative conditions,pain within 1 month after the surgery,complications within 24 months after the surgery,and clinical efficacy within 24 months after the surgery were compared between the two groups of children.Results Compared with the control group,the operation time of children in the observation group increased,the amount of intraoperative bleeding,the first postoperative exhaust time,the time of getting out of bed,the number of days with tubes after operation and the length of hospital stay after operation were decreased.The hospitalization expenses,and the excellent rate of pain score within 1 month after the operation were increased(P<0.05).Compared with the control group,the incidence of pleural effusion and incision infection,and clinical recurrence rate in the observation group were decreased,and the clinical effective rate was increased within 24 months after the operation(P<0.05).Conclusion Laparoscopic hepatic hydatid internal capsule extraction+external capsule subtotal resection in the treatment of hepatic cystic hydatid disease can effectively reduce the incidence rate of intraoperative bleeding,postoperative thoracic infection,alleviate postoperative pain and long-term complications,and promote postoperative rehabilitation.It is worthy of clinical promotion.
作者
艾尼娃·克然木
阿地来古丽·艾音丁
李万富
Ainiwa Keranmu;Adilaiguli Aiyinding;LI Wanfu(Department of Pediatric Surgery,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China;Department of Neonatology,Urumqi First People's Hospital,Urumqi 830011,China)
出处
《新疆医科大学学报》
CAS
2021年第12期1336-1340,共5页
Journal of Xinjiang Medical University
基金
省部共建国家重点实验室开放课题(SKL-HIDCA-2020-)。
关键词
肝囊型包虫病
肝包虫内囊摘除术+外囊次全切术
传统开放术
腹腔镜
远期疗效
hepatic cystic echinococcosis
liver hydatid internal cystectomy+external cyst subtotal resection
tradition-al open surgery
laparoscopy
long-term curative effect
