腹腔镜手术对Ⅲ型胆道闭锁患儿疗效及术后感染的影响

摘要

目的：探讨腹腔镜手术对Ⅲ型胆道闭锁患儿治疗效果及术后感染的影响。方法将85例Ⅲ型胆道闭锁患儿分为传统手术组（O P组）42例及腹腔镜手术组（L P组）43例，对比分析两组患者手术情况、术后炎症因子变化、手术前后肝功能指标变化、术后感染情况。结果 LP组手术时间较OP组长（P＜0．05），术中出血量、术后视觉模拟评分（VAS）少于OP组（P＜0．05），术后恢复进食时间早于OP组（P＜0．05）。LP组术后感染率低于OP组（P＜0．05）。两组患儿术前、术后1、3、6、12个月肝功能指标恢复差异无统计学意义（P＞0．05）。结论腹腔镜手术与传统手术治疗Ⅲ型胆道闭锁患儿各有利弊，临床应根据患儿实际情况选取合适的手术方式。%Objective To investigate the effects of laparoscopic operation in treating type Ⅲ child biliary atresia and its influence on postoperative infections .Methods 85 children cases of type Ⅲ biliary atresia were randomly divided into the conventional sur-gery group(OP group ,n=42) and the laparoscopic surgery group(LP group ,n=43) .The operation situation ,postoperative changes of inflammatory factors ,changes of liver function indexes before and after operation and postoperative infection were compared be-tween the two groups .Results The operative time of the LP group was longer than that of the OP group (P<0 .05) ,the intraoper-ative blood loss and the VAS scores of the LP group were less than those of OP group (P<0 .05) ,the postoperative eating recovery time of the LP group was earlier than that of the OP group (P<0 .05) ,the length of hospital stay of the LP group was shorter than that of the OP group(P<0 .05) and the postoperative infection rate of the LP group was lower than that of the OP group (P<0 . 05) .The liver function indexes recovery showed no statistically significant differences before and in postoperative 1 ,3 ,6 ,12 months between the two groups(P>0 .05) .Conclusion The laparoscopic operation and the conventional operation in treating type Ⅲ child biliary atresia have their own advantages and disadvantages .The appropriate operation mode should be selected according to the children′s actual situation .