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目的:探讨新生儿及婴儿先天性幽门肥厚性狭窄的腹腔镜治疗价值及临床效果,以促进患儿营养情况的早日恢复,保证患儿正常发育。方法:回顾分析2010年1月至2014年3月为18例具有典型呕吐病史的患儿在全麻下行腹腔镜幽门肌切开术的临床资料,术前患儿均经B超及上消化道造影确诊。结果:18例均成功完成腹腔镜手术,手术时间25~50 min;术中无出血,术后当天拔除胃管,术后第1天上午开始喂水,术后无出血、胃瘘等并发症发生,术后3~4 d出院。其中13例术后随访1~6个月,营养情况完全恢复,生长发育均恢复正常。结论:腹腔镜幽门肌切开术具有创伤小、术后并发症少、康复快、治愈率高的优点,治疗新生儿、婴儿先天性肥厚性幽门狭窄安全、有效,值得推广应用。
Objective: To explore the value and clinical effect of laparoscopic treatment of congenital pyloric hypertrophic stenosis in neonates and infants to promote the early recovery of nutritional status of children and ensure the normal development of children. Methods: The clinical data of 18 cases with typical history of vomiting under general anesthesia undergoing laparoscopic pyloric myotomy were retrospectively analyzed from January 2010 to March 2014. All patients underwent preoperative biopsy and upper gastrointestinal Contrast diagnosis. Results: All of the 18 cases were successfully performed laparoscopic surgery. The operation time was 25-50 min. There was no bleeding during operation. The gastric tube was removed on the day after operation. Water was supplied on the first day after operation. No postoperative bleeding, complications such as gastric fistula Occurred, 3 to 4 days after discharge. Among them, 13 cases were followed up for 1 to 6 months, the nutritional status was completely restored and their growth and development returned to normal. Conclusions: Laparoscopic pyloromyotomy has the advantages of less trauma, less postoperative complications, quick recovery and high cure rate. It is safe and effective in the treatment of congenital hypertrophic pyloric stenosis in newborns and infants, and it is worth popularizing and applying.