唐山市妇幼保健院小儿外科,河北 唐山 063000
Published:25 May 2023,
Received:16 September 2022,
扫 描 看 全 文
苗家园,赵晓波,徐渭贤等.高清腹腔镜下阑尾切除术治疗小儿复杂性阑尾炎的效果[J].局解手术学杂志,2023,32(05):413-415.
MIAO Jia-yuan,ZHAO Xiao-bo,XU Wei-xian,et al.Effect of high-definition laparoscopic appendectomy on complex appendicitis in children[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(05):413-415.
苗家园,赵晓波,徐渭贤等.高清腹腔镜下阑尾切除术治疗小儿复杂性阑尾炎的效果[J].局解手术学杂志,2023,32(05):413-415. DOI: 10.11659/jjssx.09E022087.
MIAO Jia-yuan,ZHAO Xiao-bo,XU Wei-xian,et al.Effect of high-definition laparoscopic appendectomy on complex appendicitis in children[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(05):413-415. DOI: 10.11659/jjssx.09E022087.
目的
2
观察高清腹腔镜下阑尾切除术在复杂性阑尾炎患儿中的治疗效果。
方法
2
选取我院收治的84例复杂性阑尾炎患儿作为研究对象,按随机数字表法分为观察组(高清腹腔镜下行阑尾切除术)和对照组(普清腹腔镜下行阑尾切除术),每组42例。比较2组手术相关指标及术后2 h、6 h、12 h、24 h的修订版面部表情疼痛量表(FRS-R)评分情况;记录术后恢复情况及并发症发生情况。
结果
2
所有患儿术中存在肉眼可见的阑尾穿孔、周围脓肿或坏疽性阑尾炎等,且经术后病理检查证实阑尾坏疽41例,阑尾穿孔26例,阑尾脓肿17例,均属于复杂性阑尾炎。与对照组相比,观察组术中出血量减少(
P
<
0.05),手术时间缩短(
P
<
0.05);2组住院费用及住院时间比较,差异均无统计学意义(
P
>
0.05)。2组术后12 h、24 h的FPS-R评分高于术后2 h、6 h(
P
<
0.05),术后24 h的FPS-R评分低于术后12 h(
P
<
0.05),观察组术后2 h、6 h、12 h、24 h的FPS-R评分均低于对照组(
P
<
0.05)。观察组术后肛门排气时间、肠鸣音恢复时间、进食时间均短于对照组(
P
<
0.05),并发症总发生率低于对照组(
P
<
0.05)。
结论
2
与普清腹腔镜相比,高清腹腔镜下阑尾切除术可缩短手术时间,减轻患儿术后疼痛,减少术中出血量,术后恢复快,并发症少,经济安全。
Objective
2
To observe the effect of high-definition laparoscopic appendectomy in children with complex appendicitis.
Methods
2
A total of 84 children with complex appendicitis admitted to our hospital were selected and divided into the observation group (underwent high-definition laparoscopic appendectomy) and control group (underwent conventional laparoscopic appendectomy) according to the random number table method
with 42 cases in each group.The surgery related indexes and facial expression pain scale-revised (FPS-R) scores 2 hours
6 hours
12 hours and 24 hours after surgery between the two groups were compared.The recovery and complications after surgery of patients in the two groups were recorded.
Results
2
All the children had visible appendiceal perforation
peripheral abscess or gangrenous appendicitis during the operation
and there were 41 cases of appendiceal gangrene
26 cases of appendiceal perforation and 17 cases of appendiceal abscess confirmed by postoperative pathological examination
all of which belonged to complex appendicitis.Compared with the control group
the observation group had less intraoperative blood loss and shorter operation time (
P
<
0.05).There was no significant difference in hospitalization costs or hospital stay between the two groups (
P
>
0.05).The FPS-R scores 12 hours and 24 hours after operation in the two groups were higher than those 2 hours and 6 hours after operation (
P
<
0.05)
and the FPS-R scores 24 hours after operation in the two groups were lower than those 12 hours after operation (
P
<
0.05)
the FPS-R scores 2 hours
6 hours
12 hours and 24 hours after operation of the observation group were lower than those of the control group (
P
<
0.05).The anal exhausting time
bowel sounds recovery time and eating time after surgery in the observation group were shorter than those in the control group (
P
<
0.05)
and the total incidence of complications was lower than that in the control group (
P
<
0.05).
Conclusion
2
Compared with conventional laparoscopic appendectomy
high-definition laparoscopic appendectomy can shorten the operation time
alleviate postoperative pain and reduce intraoperative blood loss
with quick postoperative recover and fewer complications
which is economical and safe.
普清腹腔镜高清腹腔镜阑尾切除术小儿复杂性阑尾炎
conventional laparoscopyhigh-definition laparoscopyappendectomychildrencomplex appendicitis
Di Saverio S,Podda M,De Simone B,et al.Diagnosis and treatment of acute appendicitis:2020 update of the WSES Jerusalem guidelines[J].World J Emerg Surg,2020,15(1):27.doi:10.1186/s13017-020-00306-3http://dx.doi.org/10.1186/s13017-020-00306-3.
冯伟,赵旭峰,崔华雷.儿童急性阑尾炎病因学研究进展[J].临床小儿外科杂志,2021,20(6):592-596.doi:10.12260/lcxewkzz.2021.06.016http://dx.doi.org/10.12260/lcxewkzz.2021.06.016.
Pogorelić Z,Domjanović J,Jukić M,et al.Acute appendicitis in children younger than five years of age:diagnostic challenge for pediatric surgeons[J].Surg Infect (Larchmt),2020,21(3):239-245.doi:10.1089/sur.2019.175http://dx.doi.org/10.1089/sur.2019.175.
马普能,白强,李亚东,等.脐部两孔法腹腔镜手术治疗非复杂性阑尾炎的临床研究[J].临床小儿外科杂志,2021,20(9):857-860.doi:10.12260 /lcxewkzz.2021.09.011http://dx.doi.org/10.12260/lcxewkzz.2021.09.011.
Fergo C,Burcharth J,Pommergaard HC,et al.Three-dimensional laparoscopy vs 2-dimensional laparoscopy with high-definition technology for abdominal surgery:a systematic review[J].Am J Surg,2017,213(1):159-170.doi:10.1016/j.amjsurg.2016.07.030http://dx.doi.org/10.1016/j.amjsurg.2016.07.030.
樊敦徽,常飞霞,何建宏,等.甲状腺切除手术中分别使用2D与3D腹腔镜的效果对比体会[J].中国全科医学,2019,22(s2):108-109.
Sane S,Fujita Y,Amagai T.Successful preoperative identification of fish bone causing appendicitis using 3-dimensional multidetector-CT[J].Radiol Case Rep,2021,17(3):577-580.doi:10.1016/j.radcr.2021.11.043http://dx.doi.org/10.1016/j.radcr.2021.11.043.
中华医学会小儿外科分会内镜外科学组.腹腔镜小儿阑尾切除术操作指南(2017版)[J].中华小儿外科杂志,2017,38(10):725-732.doi:10.3760/cma.j.issn.0253-3006.2017.10.002http://dx.doi.org/10.3760/cma.j.issn.0253-3006.2017.10.002.
Lawson SL,Hogg MM,Moore CG,et al.Pediatric pain assessment in the emergency department:patient and caregiver agreement using the Wong-Baker FACES and the faces pain scale-revised[J].Pediatr Emerg Care,2021,37(12):e950-e954.doi:10.1097/PEC.0000000000001837http://dx.doi.org/10.1097/PEC.0000000000001837.
Hansen GL,Kleif J,Jakobsen C,et al.Changes in incidence and management of acute appendicitis in children:a population-based study in the period 2000-2015[J].Eur J Pediatr Surg,2021,31(4):347-352.doi:10.1055/s-0040-1714655http://dx.doi.org/10.1055/s-0040-1714655.
Knaapen M,van Amstel P,van Amstel T,et al.Outcomes after appendectomy in children with acute appendicitis treated at a tertiary paediatric centre:results from a retrospective cohort study[J].Langenbecks Arch Surg,2021,406(1):163-169.doi:10.1007/s00423-020-01976-yhttp://dx.doi.org/10.1007/s00423-020-01976-y.
Koppatz H,Harju J,Sirén J,et al.Three-dimensional versus two-dimensional high-definition laparoscopy in cholecystectomy:a prospective randomized controlled study[J].Surg Endosc,2019,33(11):3725-3731.doi:10.1007/s00464-019-06666-5http://dx.doi.org/10.1007/s00464-019-06666-5.
Bhattacharjee HK,Chaliyadan S,Mishra AK,et al.Comparison of two-dimensional high-definition,ultra high-definition and three-dimensional endovision systems:an ex-vivo randomised study[J].Surg Endosc,2021,35(9):5328-5337.doi:10.1007/s00464-020-07980-zhttp://dx.doi.org/10.1007/s00464-020-07980-z.
Kanaji S,Watanabe R,Mascagni P,et al.Three-dimensional imaging improved the laparoscopic performance of inexperienced operators:a prospective trial[J].Surg Endosc,2020,34(11):5083-5091.doi:10.1007/s00464-019-07308-6http://dx.doi.org/10.1007/s00464-019-07308-6.
Botteri E,Ortenzi M,Alemanno G,et al.Laparoscopic appendectomy performed by junior aurgeons:impact of 3D visualization on surgical outcome.Randomized multicentre clinical trial(LAPSUS TRIAL)[J].Surg Endosc,2021,35(2):710-717.doi:10.1007/s00464-020-07436-4http://dx.doi.org/10.1007/s00464-020-07436-4.
Li J,Xi H,Guo X,et al.Surgical outcomes and learning curve analysis of robotic gastrectomy for gastric cancer:multidimensional analysis compared with three‑dimensional high-definition laparoscopic gastrectomy[J].Int J Oncol,2019,55(3):733-744.doi:10.3892/ijo.2019.4851http://dx.doi.org/10.3892/ijo.2019.4851.
周小兵,李冰心,陈爱军,等.3D腹腔镜手术治疗小儿阑尾周围脓肿[J].临床小儿外科杂志,2020,19(5):437-440.doi:10.3969/j.issn.1671-6353.2020.05.012http://dx.doi.org/10.3969/j.issn.1671-6353.2020.05.012.
吴开李,王连臣,符国宏.腹腔镜手术对穿孔性阑尾炎患者术后切口感染和免疫功能的影响[J].湖南师范大学学报(医学版),2020,17(2):102-106.doi:10.3969/j.issn.1673-016X.2020.02.031http://dx.doi.org/10.3969/j.issn.1673-016X.2020.02.031.
仲富瑞,程宦立,张浩,等.三维与二维腹腔镜胆囊切除术治疗胆囊良性疾病疗效与安全性比较的Meta分析[J].中国普通外科杂志,2020,29(8):936-944.doi:10.7659/j.issn.1005-6947.2020. 08.004http://dx.doi.org/10.7659/j.issn.1005-6947.2020.08.004.
0
Views
1
下载量
0
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution
京公网安备11010802024621
