腹腔镜技术在小儿腹部疾病诊治中的可行性探讨

摘要

目的：探讨腹腔镜技术在小儿腹部疾病诊治中的可行性及临床疗效。方法：回顾性分析本院2013年1月-2015年1月行腹腔镜技术诊治的194例患儿的临床资料。结果：2013年1月-2015年1月，本院小儿外科进行了包括腹腔镜下阑尾切除（63例）、疝囊高位结扎术（120例）、美克尔憩室切除（2例）、粘连性肠梗阻松解术（2例）、十二指肠穿孔修补（1例）、肠套叠松解（1例）、腹腔探查（1例）、肠系膜囊肿摘除（1例）、脾切除（1例）、性腺探查（1例）、肠重复畸形手术（1例）等术式。除1例外伤患儿经腹腔镜探查后中转开腹外，其余193例患儿均接受了腹腔镜的治疗技术，临床效果满意；并发症包括1例皮下气肿、1例阑尾切除术后单个戳孔感染、1例合并斜疝的急性阑尾炎患儿术后斜疝侧阴囊红肿，这些并发症均经保守治疗治愈；无严重并发症发生。结论：腹腔镜技术在小儿腹部疾病诊治中安全、可行，并具有微创、恢复快、痛苦小等优点，需根据医院设备条件及科室的技术水平适时开展。%Objective:To investigate the feasibility and clinical curative effect of laparoscopic techniques in the diagnosis and treatment of pediatric abdominal disease.Method:The clinical data of One-hundred and ninty-four children with pediatric abdominal disease for laparoscopic techniques in our hospital from January 2013 to January 2015 were retrospective analyzed.Result:A total number of 194 cases suffering pediatric abdominal disease were given laparoscopic procedure in the above time,including laparoscopic appendectomy(63 cases),laparoscopic hernia sac high ligation (120 cases),laparoscopic Meckel’s diverticulum excision(2 cases),laparoscopic intestinal adhesion lysis(2 cases), laparoscopic duodenal perforation neoplasty(1 case),laparoscopic intussusception lysis(1 case),laparoscopic abdominal exploration(1 case),laparoscopic mesenteric cyst excision(1 case),laparoscopic splenectomy(1 case), laparoscopic gonadal exploration(1 case),laparoscopic intestinal duplication deformity surgery(1 case),etc.193 cases received laparoscopic treatment techniques successfully except that one trauma patient received conversion to laparotomy after laparoscopic abdominal exploration.The clinical effect was satisfactory because no serious complications occurred. The complications included 1 case of subcutaneous emphysema,1 case of a single incision infection after appendectomy, 1 case of acute appendicitis with indirect hernia lateral scrotal swelling after appendectomy,these complications were cured by conservative treatment.Conclusion:Laparoscopy techniques are safe,feasible in the diagnosis and treatment of pediatric abdominal disease.Its advantages include minimally invasive,quick recovery,less pain,etc.Laparoscopic technology needs timely to be carried out according to the hospital equipment conditions and the technical level of laparoscopy.