中华小儿外科杂志
中華小兒外科雜誌
중화소인외과잡지
CHINESE JOURNAL OF PEDIATRIC SURGERY
2014年
8期
599-602
,共4页
新生儿%膈疝%腹腔镜
新生兒%膈疝%腹腔鏡
신생인%격산%복강경
Neonate%Diaphragmatic hernia%Laparoscopes
目的：对比腔镜手术和开放手术治疗新生儿膈疝的临床疗效,探讨腔镜下治疗新生儿膈疝的可行性及安全性。方法回顾性分析我院2002年6月至2014年2月采取手术治疗的59例新生儿膈疝患儿病例资料。根据手术方式分为腔镜手术组和开放手术组,其中腔镜手术组19例,10例采用胸腔镜,9例采用腹腔镜；开放手术组40例。对比两组患儿的术前资料、手术时及术后恢复情况,比较开放手术与腔镜手术相关并发症、生存率及复发率。结果两组患儿的年龄[(3.4±0.2)d比(4.1±0.5)d,P =0.654]、体质量[(3.3±0.3)kg比(3.5±0.2)kg,P =0.815]基本相同,无统计学差异。与开放组比较,腔镜组住院时间短[(14.2±2.7)d比(21.5±3.5)d,P =0.042],术后通气时间短[(1.8±0.2)d比(5.1±0.9)d,P =0.034],但手术时间长[(115.6±31.2)min 比(92.5±19.4)min,P=0.023]；腔镜组的复发率较高(15.8%比5%,P =0.164),生存率较低(94.7%比95%,P =0.966),但差异无统计学意义。近5年腔镜手术组的复发率有所降低,仍较开放组高(9%比5%,P =0.327),但无统计学差异。结论新生儿膈疝腔镜修补术治疗新生儿膈疝安全有效,其疗效与开放手术相似,且创伤小,术后恢复快,具有较好的美容效果。
目的：對比腔鏡手術和開放手術治療新生兒膈疝的臨床療效,探討腔鏡下治療新生兒膈疝的可行性及安全性。方法迴顧性分析我院2002年6月至2014年2月採取手術治療的59例新生兒膈疝患兒病例資料。根據手術方式分為腔鏡手術組和開放手術組,其中腔鏡手術組19例,10例採用胸腔鏡,9例採用腹腔鏡；開放手術組40例。對比兩組患兒的術前資料、手術時及術後恢複情況,比較開放手術與腔鏡手術相關併髮癥、生存率及複髮率。結果兩組患兒的年齡[(3.4±0.2)d比(4.1±0.5)d,P =0.654]、體質量[(3.3±0.3)kg比(3.5±0.2)kg,P =0.815]基本相同,無統計學差異。與開放組比較,腔鏡組住院時間短[(14.2±2.7)d比(21.5±3.5)d,P =0.042],術後通氣時間短[(1.8±0.2)d比(5.1±0.9)d,P =0.034],但手術時間長[(115.6±31.2)min 比(92.5±19.4)min,P=0.023]；腔鏡組的複髮率較高(15.8%比5%,P =0.164),生存率較低(94.7%比95%,P =0.966),但差異無統計學意義。近5年腔鏡手術組的複髮率有所降低,仍較開放組高(9%比5%,P =0.327),但無統計學差異。結論新生兒膈疝腔鏡脩補術治療新生兒膈疝安全有效,其療效與開放手術相似,且創傷小,術後恢複快,具有較好的美容效果。
목적：대비강경수술화개방수술치료신생인격산적림상료효,탐토강경하치료신생인격산적가행성급안전성。방법회고성분석아원2002년6월지2014년2월채취수술치료적59례신생인격산환인병례자료。근거수술방식분위강경수술조화개방수술조,기중강경수술조19례,10례채용흉강경,9례채용복강경；개방수술조40례。대비량조환인적술전자료、수술시급술후회복정황,비교개방수술여강경수술상관병발증、생존솔급복발솔。결과량조환인적년령[(3.4±0.2)d비(4.1±0.5)d,P =0.654]、체질량[(3.3±0.3)kg비(3.5±0.2)kg,P =0.815]기본상동,무통계학차이。여개방조비교,강경조주원시간단[(14.2±2.7)d비(21.5±3.5)d,P =0.042],술후통기시간단[(1.8±0.2)d비(5.1±0.9)d,P =0.034],단수술시간장[(115.6±31.2)min 비(92.5±19.4)min,P=0.023]；강경조적복발솔교고(15.8%비5%,P =0.164),생존솔교저(94.7%비95%,P =0.966),단차이무통계학의의。근5년강경수술조적복발솔유소강저,잉교개방조고(9%비5%,P =0.327),단무통계학차이。결론신생인격산강경수보술치료신생인격산안전유효,기료효여개방수술상사,차창상소,술후회복쾌,구유교호적미용효과。
Objective To evaluate the outcomes of neonates with congenital diaphragmatic hernia (CDH)undergoing open versus minimally invasive surgery.Methods A total of 59 neonatal CDH cases were recruited from June 2002 to February 2014.They were divided into minimally invasive surgery and open groups.The repair procedures included minimally invasive surgery (n =19),thoracoscopy (n = 10 ),laparoscopy (n = 9 )and open surgery (n = 40 ).The clinical data including preoperative data,treatment and postoperative management were retrospectively reviewed. The comparisons of clinical data,outcome and recurrence were made between two groups.Results Age [(3.4±0.2)vs (4.1 ±0.5)days,P =0.654]and body weight [(3.3±0.3)vs (3.5±0.2)kg, P =0.81 5]showed no inter-group difference.The overall survival rate of CDH was 94.9%(56/59). The hospitalization stay [(14.2±2.7)vs (21 .5±3.5)days,P =0.042]and postoperative duration of mechanical ventilation [(1 .8 ± 0.2)vs (5.1 ± 0.9)days,P = 0.034]had significant statistical differences (P < 0.05).The minimally invasive surgery group was significantly shorter than open-group.The operative duration [(1 1 5.6 ±3 1 .2)vs (92.5 ± 19.4)min,P =0.023]was significantly shorter in minimally invasive surgery group than open-group.However the recent 5-year recurrence rate showed no significant statistical differences (9% vs 5%,P =0.327).Conclusions As compared with open surgery,minimally invasive surgical repair has no increase in the incidence rate of operation-related complications.And the survival rate is comparable for two groups.Thus mini-invasive surgical repair is both safe and efficacious.
