CAJ | 학술논문

目的：评估快速康复外科（FTS）理念联合腹腔镜技术治疗婴儿先天性巨结肠的安全性及临床效果。方法回顾性分析南京医科大学附属南京儿童医院新生儿外科2010年6月至2013年6月接受择期手术治疗的72例年龄为2．5～5．0月的先天性巨结肠患儿的临床资料，根据家长意愿，其中33例予以快速康复外科理念指导下联合腹腔镜手术（FTS组），39例予以单纯腹腔镜手术（对照组），比较两组患儿手术以及术后肠功能恢复时间、总住院时间、住院费用和并发症发生率等情况。结果 FTS组与对照组患儿术中出血和手术时间比较，差异无统计学意义（均P＞0．05）。术后肠功能恢复时间FTS组（42±9） d，对照组（46±8） d；虽两组差异无统计学（P＝0．078），但FTS组要快于对照组。FTS组总住院时间为（10±2） d，住院费用（15316±2273）元，明显低于对照组的（14±4） d和（18641±3082）元（P＜0．01）。随访4周，两组术后并发症发生率和术后恢复情况比较，差异均无统计学意义（P＞0．05）。结论快速康复外科理念联合腹腔镜技术治疗婴儿先天性巨结肠安全、有效。
목적：평고쾌속강복외과（FTS）이념연합복강경기술치료영인선천성거결장적안전성급림상효과。방법회고성분석남경의과대학부속남경인동의원신생인외과2010년6월지2013년6월접수택기수술치료적72례년령위2．5～5．0월적선천성거결장환인적림상자료，근거가장의원，기중33례여이쾌속강복외과이념지도하연합복강경수술（FTS조），39례여이단순복강경수술（대조조），비교량조환인수술이급술후장공능회복시간、총주원시간、주원비용화병발증발생솔등정황。결과 FTS조여대조조환인술중출혈화수술시간비교，차이무통계학의의（균P＞0．05）。술후장공능회복시간FTS조（42±9） d，대조조（46±8） d；수량조차이무통계학（P＝0．078），단FTS조요쾌우대조조。FTS조총주원시간위（10±2） d，주원비용（15316±2273）원，명현저우대조조적（14±4） d화（18641±3082）원（P＜0．01）。수방4주，량조술후병발증발생솔화술후회복정황비교，차이균무통계학의의（P＞0．05）。결론쾌속강복외과이념연합복강경기술치료영인선천성거결장안전、유효。
Objective To evaluate the safety and efficacy of fast track surgery (FTS) combined with laparoscopy in the treatment of infant Hirschsprung disease. Methods Clinical data of 72 infants with Hirschsprung disease undergoing elective pull-through surgery from June 2010 to June 2013 were retrospectively summarized. The patients were divided into two groups: fast track surgery combined with laparoscopy group (FTS group, n=33) and laparoscopic surgery with traditional management perioperatively (control group, n=39). Postoperative intestinal function recovery, hospital stay, cost of hospitalization, complications were compared and postoperative recovery was followed-up for four weeks. Results There were no significant differences in intraoperative blood loss and operative time between FTS and control group(both P>0.05). The recovery of bowel movement was earlier in the FTS group but the difference was not statistically significant (P=0.078). The hospital stay was shorter [(10±2) d vs. (14±4) d] and cost of hospitalization was lower[(15 316±2273) Yuan vs. (18 641±3082) Yuan] in FTS group than those in control group(P<0.01). Postoperative complications and recovery conditions during 4 weeks follow-up were similar between the two groups. Conclusion Fast track surgery combined with laparoscopy in the treatment of infant Hirschsprung disease is safe and effective.