临床小儿外科杂志2024，Vol.23Issue(1)：22-28,7.DOI:10.3760/cma.j.cn101785-202310051-005
功能性微创理念在先天性巨结肠患儿围手术期应用临床研究
Clinical application of functional minimally invasive surgery for Hirschsprung's disease
摘要
Abstract
Objective To explore the feasibility and clinical efficacy of functional minimally inva-sive(FMI)concept in perioperative management of children with Hirschsprung's disease(HSCR).Methods From March 2019 to March 2023,the relevant clinical data were retrospectively reviewed for 82 HSCR children undergoing heart-shaped laparoscopic anastomosis.They were assigned into two groups of FMI(n=45)and non-FMI(n=37).The former group was composed of 34 boys and 1 1 girls with a mean age of(1.31±0.96)years while the latter group had 28 boys and 9 girls with a mean age of(1.16 ±0.63)years.The differences of initial oral feeding timing,initial time of postoperative defecation,post-operative length of stay,postoperative timing of anal tube extraction,pain assessment and postoperative complications were compared between two groups.The measurement data were expressed as x±s.Inde-pendent sample t test was utilized for examining the difference of continuous variables in a normal distribu-tion and Mann-Whitney U test for variables in a abnormal contribution.Categorical variables were compared by Chi-square analysis or Fisher's exact test.Results In comparison with non-FMI group,FMI group had a significantly shorter time for postoperative removal of anal tube[(9.23±1.47)vs.(11.50±1.91)day,P=0.001].Time to initial postoperative oral feeding[(36.92±19.01)vs.(56.76±17.22)h,P=0.005]was significantly shorter.The incidence of postoperative complications declined markedly(P=0.038).Pain scores at 0/24 h post-operation dropped obviously in FMI group as compared with non-FMI group(P＜0.05).Krick-enbeck scores of anal function spiked in both groups at Month 6 post-operation and the inter-group difference was statistically significant(P＜0.05).Initial time of postoperative defecation[(27.74±13.95)hvs.(28.91 ±12.61)h,P=0.937],length of hospitalization stay[(11.56±4.18)hvs.(13.19±3.67)day,P=0.473]and hospital expenses[(43 087.23±4 729.14)yuan vs.(62 036.34±3 129.77)yuan,P=0.312]were compared and the differences were not statistically significant.Conclusions Surgical application of FMI con-cept for HSCR is both efficacious and safe.It may accelerate postoperative recovery,reduce postoperative pain,minimize drainage-related discomforts and lower the occurrence of postoperative complications关键词
先天性巨结肠/功能性微创/腹腔镜/外科手术/儿童Key words
Hirschsprung's Disease/Functional Minimally Invasive/Laparoscopic/Surgical Proce-dures,Operative/Child引用本文复制引用
阿迪拉·阿不都萨拉木,王文静,朱天琦,熊晓峰,贺颖,刘率斌,杨继鑫,冯杰雄..功能性微创理念在先天性巨结肠患儿围手术期应用临床研究[J].临床小儿外科杂志,2024,23(1):22-28,7.基金项目
国家自然科学基金项目(81401240) （81401240）
湖北省自然科学基金项目(2022CBF134) （2022CBF134）
湖北省卫生健康委员会科研基金(WJ2021M107)National Natural Science Foundation of China(81401240) （WJ2021M107）
Hubei Provincial Natural Sci-ence Foundation(2022CBF134) （2022CBF134）
Research Fund of Hubei Provincial Health Commission(WJ2021M107) （WJ2021M107）
