经脐开腹幽门环肌切开术治疗先天性幽门肥厚性狭窄临床观察.docVIP

经脐开腹幽门环肌切开术治疗先天性幽门肥厚性狭窄临床观察[摘要] 目的：通过比较经脐开腹幽门环肌切开术和腹腔镜幽门环肌切开术治疗先天性幽门肥厚性狭窄，探讨适合基层医院的最佳治疗方案。方法：60例先天性肥厚性幽门狭窄患儿随机分为经脐开腹组、腹腔镜组，每组30例，两组患儿一般情况均无显著差异，观察两组患儿手术时间、术后住院天数、住院费用、美观满意度及术后不良反应。结果：两组手术时间、术后住院天数、住院费用比较均无明显差异，随访3个月家长对切口美观满意率无显著差异，两组患儿术后分别有13例和17例出现呕吐，组间比较无明显差异，且均在出院前消失，其他不良反应比较均无显著差异。结论：腹腔镜幽门环肌切开术和经脐开腹幽门环肌切开术治疗先天性幽门肥厚性狭窄的临床效果及美观程度相近，经脐开腹这一术式更适合在基层医院推广。 [关键词] 幽门；幽门狭窄；腹腔镜；经脐开腹幽门环肌切开术 [中图分类号] R573.6 [文献标识码]A[文章编号]1674-4721（2011）07（b）-017-02 Clinical observation of open pyloromyotomy through umbilical in infants with congenital hypertrophic pyloric stenosis NING Liangshu The People′s Hospital of Yinan County, Shandong Province, Yinan 276500, China [Abstract] Objective: Through comparing the umbilical sigmoidectomy pylorus ring muscle dissection and laparoscopich. Pylori treatment of congenital craniotomy ring muscle hypertrophic narrow, explore the best treatment plan of basic-level hospitals. Methods: 60 children with congenital hypertrophic pyloric stenosis were randomly divided into two groups, 30 cases in laparoscopic pyloromyotomy group and the other 30 cases in open pyloromyotomy group. Clinical date including operation time, postoperative hospital stay, hospital charges, aesthetic satisfaction and adverse reactions. Results: No significant differences were noted in the operation time, postoperative hospital stay, hospital charges and adverse reactions. During 3 months follow-up, parents had same satisfaction in the incision appearance. Conclusion: Open pyloromyotomy through umbilical is a safe and efective technique for infants with congenital hypertrophic pyloric stenosis and is more suitable for promotion in the primary hospital. [Key words] Pylorus; Pyloric stenosis; Laparoscopic; The umbilical incision abdominal muscle pyloric ring 先天性肥厚性幽门狭窄（CHPS）是小儿外科的常见疾病，占小儿消化道先天畸形的第3位[1]，治疗以传统外科手术为主，随着小儿腹腔镜技术的发展，近年来腹腔镜下幽门环肌切开术数量逐渐增多，笔者对开腹手术及腹腔镜术进行比较，旨在探讨适合基层医院的最佳治疗方案。 1 资料与方法 1.1 一般资料 2006年1月～2009年12月，本院共收治先天性肥厚性幽门狭窄患儿60例，60例患儿均行彩超检查明确诊断