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目的 :探讨超声检查在腹腔镜治疗婴幼儿急性阑尾炎的临床价值与诊疗体会。方法:回顾性分析2014年1月——2016年6月符合纳入研究条件的116例婴幼儿急性阑尾炎(2~6岁)患者的临床资料,所有患者行腹腔镜阑尾切除(LA)手术。结果:116例患儿全部完成手术,无中转开腹病例,无阑尾动脉出血、腹腔残余脓肿及粘连性肠梗阻的病例。手术时间(20±7.3)min,术中出血量为(5±1.6)mL,术后引流管留置时间(2±1.8)d,术后住院时间(5±1.1)d。术后腹胀4例,切口感染1例,3——6天处理后恢复良好;随访中术后无粘连性肠梗阻的病例。结论:熟练掌握观察炎性改变后阑尾的超声影像技巧,联合腹腔镜治疗婴幼儿急性阑尾炎具有安全性高,可行性强,创伤小,恢复快,并发症少,远期疗效显著等特点。
Objective: To investigate the clinical value of ultrasound in the treatment of acute appendicitis in infants and young children by laparoscopy. Methods: The clinical data of 116 infants and young children with acute appendicitis (aged 2-6 years) who met the study conditions from January 2014 to June 2016 were retrospectively analyzed. All patients underwent laparoscopic appendectomy (LA). Results: All the 116 children completed the operation without conversion to laparotomy, without appendicitis, residual abdominal abscess and adhesive intestinal obstruction. The operation time (20 ± 7.3) min, intraoperative blood loss was (5 ± 1.6) mL, postoperative drainage tube indwelling time (2 ± 1.8) d, postoperative hospital stay (5 ± 1.1) d. Postoperative abdominal distension in 4 cases, incision infection in 1 case, 3-6 days after treatment, recovery was good; follow-up in the case of non-adhesive intestinal obstruction. Conclusion: Proficiency in observation of inflammatory changes in the appendix after ultrasound imaging techniques, combined with laparoscopic treatment of acute appendicitis in infants and young children with high safety, feasibility, trauma, rapid recovery, fewer complications, long-term effect is significant and so on.