[1]赵成鹏* 段永福 周晓波 梅孝臣.胸腔镜与开放手术治疗小儿先天性膈膨升的比较[J].中国微创外科杂志,2015,15(6):502-514.
　Zhao Chengpeng,Duan Yongfu,Zhou Xiaobo,et al.Comparative Study Between Thoracoscopic and Open Surgery for Congenital Diaphragmatic Eventration in Children[J].Chinese Journal of Minimally Invasive Surgery,2015,15(6):502-514.
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胸腔镜与开放手术治疗小儿先天性膈膨升的比较()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
15
期数:
2015年6期
页码:
502-514
栏目:
临床论著
出版日期:
2015-06-20

文章信息/Info

Title:
Comparative Study Between Thoracoscopic and Open Surgery for Congenital Diaphragmatic Eventration in Children
作者:
赵成鹏* 段永福 周晓波 梅孝臣
河南省南阳市中心医院小儿外科，南阳473000
Author(s):
Zhao Chengpeng;  Duan Yongfu;  Zhou Xiaobo;  et al.
Department of Pediatric Surgery, Nanyang Central Hospital, Nanyang 473000, China
关键词:
膈膨升; 胸腔镜; 畸形; 婴幼儿
Keywords:
Diaphragmatic eventration; Thoracoscope; Malformation; Children
分类号:
R726.1
文献标志码:
A
摘要:
目的比较胸腔镜与开放手术治疗小儿先天性膈膨升的效果。方法2008年1月~2010年2月我院收治35例先天性膈膨升，年龄3个月~3.5岁，2009年1月前收治的17例行开放手术（开放组），右侧膈膨升采用开胸折叠修补膈肌，左侧膈膨升采用开腹手术修补；2009年1月以后的18例行胸腔镜修补膈肌（胸腔镜组）。比较2组手术时间、术中出血量、术中输血例数、放置胸腔引流例数、胸腔引流时间、术后膈肌下降情况、术后住院时间、复发率。结果与开放组比较，腹腔镜组手术时间长［（75.3±5.0）min vs. （64.2±5.1）min，t=6.501，P=0.000］，但术中出血少［（5.6±0.4）ml vs. （18.5±1.2）ml，t=-43.172，P=0.000］，放置胸腔引流比例少［27.8%（5/18） vs. 100.0%（17/17），P=0.000］，胸腔引流时间短［（1.9±0.1）d (n=5) vs. （3.5±0.4）d，t=-8.723，P=0.000］，术后住院时间短［（3.7±0.4）d vs. （5.6±0.5）d，t=-12.450，P=0.000］。2组术中输血例数、术后膈肌下降程度及复发率差异无显著性。结论胸腔镜治疗小儿先天性膈膨升与传统开放手术比较具有出血少、恢复快等优点。
Abstract:
ObjectiveTo compare clinical effects between thoracoscopic and open surgery for congenital diaphragmatic eventration in children.MethodsOut of 35 children aged from 3 months to 3.5 years old with congenital diaphragmatic eventration, 17 cases (open group) received open surgery between January 2008 and January 2009 and 18 cases (thoracoscopic group) received thoracoscopic surgery between January 2009 and January 2010. In the open group, thoracotomy for diaphragmatic repair was applied to those with right diaphragmatic eventration while laparotomy was used in those with left diaphragmatic eventration. In the thoracoscopic group, minimally invasive surgery under thoracoscope was performed. The operation time, blood loss, number of intraoperative transfusion, cases needing chest drainage, duration of drainage, diaphgram muscles descent after operation, length of hospital stay, and incidence of recurrence were compared between the two groups.ResultsAs compared with the open group, the thoracoscopic group received longer operation time ［(75.3±5.0) min vs. (64.2±5.1) min, t=6.501, P=0.000］, less blood loss ［(5.6±04) ml vs. (18.5±1.2) ml, t=-43.172, P=0.000］, lower proportion of chest drainage ［27.8% (5/18) vs. 100.0% (17/17), P=0.000］, shorter duration of drainage ［(1.9±0.1) d vs. (3.5±0.4) d, t=-8.723, P=0.000］, and shorter length of stay ［(3.7±0.4) d vs. (5.6±0.5) d, t=-12.450, P=0.000］. No significant differences were recorded between the two groups in number of intraoperative transfusion, diaphgram muscles descent after operation, and incidence of recurrence.ConclusionThoracoscopic surgery has characteristics of less intraoperative blood loss and rapid postoperative recovery in the treatment of congenital diaphragmatic eventration in children.

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备注/Memo

备注/Memo:
*通讯作者，E-mail：zhaochengpeng112@163.com
更新日期/Last Update: 2015-06-20