临床小儿外科杂志2018，Vol.17Issue(3)：184-189,6.DOI:10.3969/j.issn.1671-6353.2018.03.006
两种手术方式治疗先天性食管闭锁并食管气管瘘的对比研究
Comparative study of thoracoscopy and thoracotomy in the treatment of congenital esophageal atresia complicated with esophagotracheal fistula
摘要
Abstract
Objective To explore the clinical value of thoracoscopy in the treatment of congenital esoph -ageal atresia(CEA)complicated with esophagotracheal fistula(ETF). Methods Forty-eight CEA/ETF chil-dren were operated from February 2014 to February 2017.Twenty-eight underwent traditional thoracic surgery (traditional group)while another 20 cases had thoracoscopy(thoracoscopy group).The clinical efficacies of two methods were compared and the levels of pain, stress and other related blood parameters before and after operation in two groups were detected and compared.Results The amount of operative bleeding was signifi-cantly lower in thoracoscopy group than that in traditional group(t=14.585,P<0.05).No significant differ-ence existed in operative duration,blind-end distance and postoperative breathing machine using time between two groups(P>0.05).In thoracoscopy group,20 patients were successfully operated and there was no con-version into thoracotomy; in traditional group, 2/28 patients underwent gastrostomosis.Before operation, no significant inter-group differences existed in serum levels of nitrogen oxide(NO),interleukin-1β(IL-1β),in-terleukin-6(IL-6),5-hydroxytryptamine(5-HT)or tumor necrosis factor-alpha(TNF-α)(P>0.05);at 12 h and 24 h post-operation,the serum levels of NO,IL-1β,IL-6,5-HT and TNF-αwere significantly lower in tho-racoscopy group than those in traditional group(P<0.05);After operation,the complication rates of thoracos-copy and traditional groups were 35% and 28.57% respectively.No significant inter-group difference existed in the incidence of operative complications(χ2=1.222,P=0.269).The cure rate was 90% in thoracoscopy group versus 92.86%in traditional group.The difference was not statistically significant(χ2=0.125, P=0.724).Conclusion As compared with thoracotomy,thoracoscopy offers such advantages as reducing the a-mount of intraoperative bleeding,effectively reducing postoperative inflammation,pain and stress response and improving prognosis.It has the value of clinical popularization.关键词
胸腔镜/食管闭锁/食管气管瘘/治疗应用Key words
Thoracoscopes/Esophageal Atresia/Tracheoesophageal Fistula/Therapeutic Uses引用本文复制引用
徐新利,王皓洁,张治超,王敏..两种手术方式治疗先天性食管闭锁并食管气管瘘的对比研究[J].临床小儿外科杂志,2018,17(3):184-189,6.基金项目
自治区科技支疆项目计划项目(2015911117) （2015911117）
