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目的探讨腹腔镜辅助体外肾盂成形术与小切口肾盂成形术治疗婴儿期先天性肾积水的临床疗效。方法回顾性分析67例婴儿期先天性肾积水手术治疗患儿的临床资料,其中腹腔镜辅助体外肾盂成形手术31例为腹腔镜辅助组,小切口肾盂成形术36例为小切口手术组。比较2组手术时间、术中出血量、术后肠道恢复时间、术后住院时间、术后并发症发生率、肾盂分离减少值和肾小球滤过率增加值。结果腹腔镜辅助组手术时间[(78±12)min]较小切口手术组[(70±10)min]长(P<0.05),术后住院时间[(7.5±1.2)d]、术后肠道恢复时间[(1.2±0.2)d]均短于小切口手术组[(8.5±1.3)d、(1.5±0.5)d](P<0.05),术中出血量[(10.1±2.2)mL]少于小切口手术组[(12.6±3.2)mL](P<0.05);腹腔镜辅助组术后并发症发生率(9.6%)、肾盂分离减少值[(16.4±9.6)mm]、肾小球滤过率增加值[(10.3±2.7)mL/min]与小切口手术组[8.3%、(17.3±8.2)mm、(9.6±3.6)mL/min]比较差异无统计学意义(P>0.05)。结论腹腔镜辅助体外肾盂成形术治疗婴儿期先天性肾积水可达到与小切口肾盂成形术相同效果,患儿术后恢复快、住院时间短。
Objective To investigate the clinical efficacy of laparoscopic assisted extrapyratic pyeloplasty and small incision pyeloplasty for the treatment of congenital hydronephrosis in infancy. Methods A retrospective analysis of 67 cases of infants with congenital hydronephrosis in children with clinical data, including laparoscopic assisted external pyeloplasty in 31 cases of laparoscopic auxiliary group, 36 cases of small incision pyeloplasty for small incision surgery group. The operation time, intraoperative blood loss, postoperative intestinal recovery time, postoperative hospital stay, postoperative complications, reduction of pelvic separation and glomerular filtration rate were compared. Results The operation time of the laparoscopic-assisted group was longer (78 ± 12 min) than that of the small incision group (70 ± 10 min) (P <0.05), and the postoperative length of stay (7.5 ± 1.2) Intestinal recovery time (1.2 ± 0.2) d was shorter than that in the small incision group (8.5 ± 1.3 d, 1.5 ± 0.5 d) (P <0.05) (P <0.05); The incidence of postoperative complications (9.6%) in laparoscopic auxiliary group and the decrease of renal pelvic separation [(16.4 ± 9.6) mm] were lower in small incision group than in small incision group [(12.6 ± 3.2) There was no significant difference in the value of glomerular filtration rate [(10.3 ± 2.7) mL / min vs that of the small incision group [8.3%, (17.3 ± 8.2) mm, (9.6 ± 3.6) mL / min P> 0.05). Conclusions Laparoscopy-assisted extrapyveline pyeloplasty for infantile congenital hydronephrosis can achieve the same effect as small incision pyeloplasty. The children recover quickly and have shorter hospital stay.