快速康复外科在腹腔镜手术治疗小儿肠套叠中的应用体会.docVIP

快速康复外科在腹腔镜手术治疗小儿肠套叠中的应用体会 韩月锋、李灿、梁志宏、赵象文、刘书强 南方医科大学附属小榄人民医院(广东 中山小榄 528415) 【摘要】目的 探讨快速康复外科在腹腔镜手术治疗小儿肠套叠中的价值及安全性。方法 选择我院2009年6月至2014年6月收治的小儿急性肠套叠78例，随机分为快速康复组（39例）和对照组（39例）。比较两组的术后肠蠕动恢复时间、住院时间及住院费用，并观察记录术后不良反应发生率情况。结果 所有患儿均顺利完成，无一例死亡，无中转开腹手术，术后无肠瘘、腹腔脓肿及切口感染等并发症发生。手术时间22-56 min，平均28.5 min。术中出血量5-8 ml，平均6.5 ml。在术后肠蠕动恢复时间、术后不良反应发生率、住院时间及住院费用方面，快速康复组均低于对照组，差异有统计学意义(P 0.05）。所有患儿平均随访10个月（3～24个月），无脐疝及粘连性肠梗阻等并发症。结论 快速康复外科应用于腹腔镜手术治疗小儿肠套叠是安全、可行的，具有康复快、创伤少等优点。 【关键词】小儿肠套叠；腹腔镜复位；快速康复外科 Application of Fast Track Surgery on Laparoscopic Reduction of Introsusception for Children HAN Yuefeng；LI Can；LIANG Zhihong；ZHAO Xiangwen；LIU Shuqiang (Department of General Surgery，Xiaolan Hospital Affiliated to Southern Medical University , Zhongshan 528415, China) [Abstract] Objective To explore the clinic value and safety of fast track surgery on laparoscopic reduction of introsusception for children. Methods Seventy eight children diagnosed with intussusceptions from January 2009 to January 2014, were divided into fast track group(39 cases) and control group(39 cases), randomly . The intestinal function recovery, hospital stay, hospital cost and complications were recorded. Results The operation was completed in all the cases, none of them died or conversion to open surgery. The operation time was 22-56 minutes（average 28.5minutes）, the blood loss was 5-8 ml（average 6.5 ml）. There were no complications occurred, such as intestinal fistula，peritoneal abscess and incision infection. Compared with control group, fast track group had faster intestinal function recovery, shorter hospital stay and lower hospital cost. The differences were statistically significant (P 0.05). All patients were followed up for an average of 10 months (3 - 24 months), no umbilical hernia and adhesive intestinal obstruction were observed. Conclusion Application of fast track surgery on laparoscopic reduction of introsusception is effective and safe for children, with advantages of less injury and more rapi