摘要
目的:探究新生儿肠闭锁和狭窄采用经脐单孔腹腔镜手术治疗的临床经验。方法:选取2022年1月—2024年2月收治的67例肠闭锁和狭窄新生儿,按手术方式分为两组:观察组58例实施经脐单孔腹腔镜手术,对照组9例采取开腹手术,对比两组临床治疗效果。结果:两组患儿手术均顺利完成。观察组术后3例出现并发症,其中1例为伤口感染、2例为功能性肠梗阻,经肠外营养支持、中药灌肠等对症治疗及抗感染处理后均痊愈;对照组术后4例发生并发症,包括2例伤口感染、2例黏连性肠梗阻,均经二次手术行黏连松解术及抗感染治疗后治愈。经对比,观察组在手术时间与出血量、术后经口喂养时间和术后全量经口喂养时间等指标对比上均较对照组好(P<0.05)。观察组术后并发症个例较少(P<0.05)。出院后随访1年发现,两组患儿的体格发育情况均显著改善,与正常健康儿无异,均无胃肠道症状,营养情况可。结论:肠闭锁和狭窄新生儿选择经脐单孔腹腔镜手术治疗,可有效改善临床症状,术中出血量较少,不良并发症少,出院后患儿体格发育情况较好,预后结局可观,值得临床推广。
Objective:To explore the clinical experience of transabdominal single port laparoscopic surgery for neonatal intestinal atresia and stenosis.Method:67 newborns with intestinal atresia and stenosis admitted from January 2022 to February 2024 were selected and divided into two groups according to surgical methods:the observation group(58 cases)underwent single port laparoscopic surgery via the umbilicus,and the control group(9 cases)underwent open surgery.The clinical treatment effects of the two groups were compared.Result:Both groups of children underwent successful surgeries.There were 3 cases of postoperative complications in the observation group,including 1 case of wound infection and 2 cases of functional intestinal obstruction.After symptomatic treatment such as parenteral nutrition support,traditional Chinese medicine enema,and anti infection treatment,all patients recovered;Four cases of postoperative complications occurred in the control group,including two cases of wound infection and two cases of adhesive intestinal obstruction,all of which were cured after a second surgery with adhesive release and anti infection treatment.After comparison,the observation group performed better than the control group in terms of surgical time and bleeding volume,postoperative oral feeding time,and postoperative total oral feeding time(P<0.05).There were fewer cases of postoperative complications in the observation group(P<0.05).After a one-year follow-up after discharge,it was found that the physical development of both groups of children improved significantly,which was no different from that of normal healthy children.There were no gastrointestinal symptoms in both groups,and their nutritional status was good.Conclusion:Laparoscopic surgery via umbilical single port can effectively improve clinical symptoms,reduce intraoperative bleeding,minimize adverse complications,and improve physical development in newborns with intestinal atresia and stenosis after discharge.The prognosis is promising and worthy of clinical promotion.
出处
《妇女》
2025年第20期251-253,共3页
关键词
新生儿
经脐单孔腹腔镜手术
肠闭锁
肠狭窄
Newborn
Transumbilical single port laparoscopic surgery
Intestinal atresia
Intestinal stenosis
