本文選題：小兒 + 微創(chuàng)��； 參考：《青島大學(xué)》2017年碩士論文

【摘要】：目的:研究對腹腔鏡微創(chuàng)手術(shù)治療先天性膽管擴(kuò)張癥的臨床應(yīng)用對比研究分析。方法:搜集整理濟(jì)寧醫(yī)學(xué)院附屬湖西醫(yī)院小兒外科(單縣中心醫(yī)院小兒外科)2010年1月至2016年12月先天性膽管擴(kuò)張癥的住院患兒臨床病例資料,依據(jù)手術(shù)方式的不同分為觀察組和對照組。其中觀察組治療方案采用腹腔鏡微創(chuàng)手術(shù),對照組治療方案采用傳統(tǒng)開腹手術(shù)�？偨Y(jié)分析兩組患兒平均手術(shù)時間、術(shù)中出血量、腸外營養(yǎng)時間、住院時間、治療效果、術(shù)后并發(fā)癥等情況。應(yīng)用統(tǒng)計學(xué)分析評分進(jìn)行相關(guān)方面比較,對其臨床療效獲得客觀、真實(shí)、準(zhǔn)確的評價。結(jié)果:腹腔鏡微創(chuàng)治療先天性膽管擴(kuò)張癥,手術(shù)中出血量少,手術(shù)后出現(xiàn)吻合口瘺、膽漏、腸襻梗阻等并發(fā)癥的風(fēng)險明顯降低。腹腔鏡患兒術(shù)后恢復(fù)快、住院時間短、而且切口隱蔽,切口瘢痕小。本研究中采用腹腔鏡微創(chuàng)治療先天性膽管擴(kuò)張癥患兒與傳統(tǒng)手術(shù)治療比較,觀察組患兒的手術(shù)時間比對照組手術(shù)時間長;觀察組術(shù)中出血量、腸外營養(yǎng)時間、以及平均住院時間均顯著低于對照組,差異有統(tǒng)計學(xué)意義(P0.05);對照組患兒術(shù)后并發(fā)癥發(fā)生比例(36%)與觀察組患兒術(shù)后并發(fā)癥發(fā)生比例(11.1%)相比,差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:同開腹手術(shù)對比,腹腔鏡微創(chuàng)治療先天性膽管擴(kuò)張癥雖耗時長,但能顯著減少出血量,縮短腸外營養(yǎng)與住院時間,恢復(fù)快,術(shù)后并發(fā)癥發(fā)生率、復(fù)發(fā)率低,進(jìn)而有利促進(jìn)患兒的預(yù)后康復(fù)進(jìn)程,臨床應(yīng)用效果十分顯著,值得積極應(yīng)用與推廣。
[Abstract]:Objective: to study the clinical application of laparoscopic minimally invasive surgery in the treatment of congenital cholangiectasis.Methods: the clinical data of inpatients with congenital biliary dilatation in Huxi Hospital affiliated to Jining Medical College (Department of Pediatric surgery, Shanxian Central Hospital) from January 2010 to December 2016 were collected and analyzed.According to the different operation methods were divided into observation group and control group.The observation group was treated by laparoscopic minimally invasive surgery, the control group was treated by traditional open surgery.The average operation time, intraoperative blood loss, parenteral nutrition time, hospitalization time, therapeutic effect and postoperative complications were summarized and analyzed in the two groups.The clinical efficacy was evaluated objectively, truthfully and accurately by statistical analysis.Results: the risk of complications such as anastomotic leakage bile leakage and intestinal loop obstruction after operation was significantly reduced.Laparoscopic children recovered quickly, hospital stay was short, incision was concealed and scar was small.In this study, laparoscopic minimally invasive treatment of children with congenital bile duct dilatation compared with the traditional surgical treatment, the observation group children's operation time longer than the control group, the observation group intraoperative blood loss, parenteral nutrition time,The average hospitalization time was significantly lower than that in the control group (P 0.05), and the incidence of postoperative complications in the control group was 36% (P < 0.01), which was significantly higher than that in the observation group (P 0.05).Conclusion: compared with open surgery, laparoscopic minimally invasive treatment of congenital cholangiectasis may take a long time, but it can significantly reduce the amount of bleeding, shorten the time of parenteral nutrition and hospital stay, recover quickly, and the incidence of postoperative complications and recurrence rate is low.It is beneficial to promote the prognosis and rehabilitation process of children, and the clinical application effect is very remarkable, which is worthy of active application and promotion.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R726.5

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