CAJ | 학술논문

目的：探讨腹腔镜下膈肌折叠术治疗小儿先天性右侧膈膨升的可行性。方法选取2002年1月至2013年12月于本院诊断为右侧膈膨升，并行膈肌折叠术的患儿17例，其中7例采取开放性手术（均经腹完成手术），为开放手术组；10例采取腔镜手术，为腹腔镜手术组。结果17例手术均获成功，术后胸片（DR）复查膈肌反常运动消失，Kienbock 征均为阴性。治愈16例中，经开放手术治愈6例，腹腔镜手术治愈10例。开放手术组平均手术时间145 min，术后住院时间（11.19±2.29）d，术后1例并发切口感染，经换药至切口愈合出院；腹腔镜手术组平均手术时间130 min，术后住院时间（8.86±2.31）d，无一例发生并发症。随访半年至2年，无一例复发。结论腹腔镜治疗膈膨升相对安全，创口小，恢复快，效果满意，且可实现对腹腔其他脏器的探查，是值得推广的微创手术方式。
목적：탐토복강경하격기절첩술치료소인선천성우측격팽승적가행성。방법선취2002년1월지2013년12월우본원진단위우측격팽승，병행격기절첩술적환인17례，기중7례채취개방성수술（균경복완성수술），위개방수술조；10례채취강경수술，위복강경수술조。결과17례수술균획성공，술후흉편（DR）복사격기반상운동소실，Kienbock 정균위음성。치유16례중，경개방수술치유6례，복강경수술치유10례。개방수술조평균수술시간145 min，술후주원시간（11.19±2.29）d，술후1례병발절구감염，경환약지절구유합출원；복강경수술조평균수술시간130 min，술후주원시간（8.86±2.31）d，무일례발생병발증。수방반년지2년，무일례복발。결론복강경치료격팽승상대안전，창구소，회복쾌，효과만의，차가실현대복강기타장기적탐사，시치득추엄적미창수술방식。
Objetive To investigate the feasibility of the treatment of laparoscopic diaphragmatic plica-tion of right side congenital diaphragmatic eventration. Methods To choose 1 7 cases who were diagnosed as“the right side congenital diaphragmatic eventration”and treated by the surgery of diaphragmatic plication from January 2002 to December 201 3 in our hospital inpatient,in which 7 cases undergoing with open surgery (ab-dominal surgical approach),1 0 routine endoscopic surgery. Results Diaphragmatic plication surgery were successful in treating these 1 7 cases of children with diaphragmatic eventration,DR reviewed that paradoxical diaphragmatic movement disappeared and Kienbock sign were negative postoperative.1 6 patients were cured, including six cases of open surgery,in which one case in one month old neonatal died of respiratory failure due to severe pneumonia at 1 1 days after open surgery ;1 0 cases of laparoscopic surgery were all cured .Mean op-erative time was 1 45 minutes in open surgery group,postoperative hospital stay (1 1 .1 9 ±2.29)d.1 case of concurrent postoperative wound infection,dressing to wound healing to discharged .Laparoscopic surgery time was 1 30 minutes on average,postoperative hospital stay (8.86 ±2.31 )d,no complications .Follow-up of six months to two years without recurrence. Conclusions Laparoscopic diaphragm eventration is relatively safe, small incision,quick recovery,satisfactory results can be achieved and could have an exploration of other or-gans in abdominal cavity,is worthy of promotion and application of minimally invasive surgical techniques.