经脐两孔法与传统两孔法腹腔镜下幽门环肌切开术的对照研究

卢朝祥，苗峰，李中文，王琪 *

西安市儿童医院新生儿外科，陕西 西安，710003

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摘要：

目的 探讨经脐两孔法与传统两孔腹腔镜下幽门环肌切开术的临床效果。方法 回顾性分析我院 2013 年 1 月至 2017 年1 月的收治的 109 例先天性肥厚性幽门狭窄患儿的临床资料，根据手术方式不同分为单部位组（52 例）和传统组（57 例），比较两组患儿的临床效果。结果 所有患儿均顺利完成手术，单部位组 1 例患儿幽门呈勾形走向无法完全暴露，为避免切开不全，增加一个 Trocar 完成手术；传统组 1 例患儿出现切口感染；两组患儿的手术时间、术中出血量、住院时间、并发症等方面无明显差异（P>0.05）；术后随访 3 月，单部位组患儿的瘢痕评分高于传统组（P<0.05）。结论 经脐部单部位只需经脐两孔即可完成腹腔镜下幽门环肌切开术，同时比传统两孔法手术瘢痕隐蔽性更好，美容效果更好，值得推广。

关键词：幽门肥厚性狭窄；腹腔镜；脐部；幽门环肌切开术

中图分类号：R726.5文献标志码：A文章编号：2096-1413(2018)03-0062-03

Effect of transumbilical double-port and traditional double-port pyloromyotomy under laparoscopic
LU Chao-xiang, MIAO Feng, LI Zhong-wen, WANG Qi *
（Neonatal Surgery Department, Xi````an Children````s Hospital, Xi````an 710003, China）
ABSTRACT: Objective To discuss the clinical effects of transumbilical double-port and traditional double-port pyloromy-otomy under laparoscopic. Methods The clinical data of 109 cases of congenital hypertrophic pyloric stenosis admitted in our hospital from January 2013 to January 2017 were retrospectively analyzed, and were divided into single group (52 cas-es) and traditional group (57 cases) according to different surgical methods. The clinical effects of two groups were com-pared. Results All children successfully completed the operation, 1 case in the single group with pyloric hook was not fullyexposed, in order to avoid incomplete incision, a Trocar surgery was added and completed the surgey; 1 case in the tradi-tional group ocurred incision infection; the operation time, intraoperative blood loss, hospitalization time and complicationsof the two groups had no significant difference (P>0.05); after 3 months of follow-up, the score of scars in the single group was higher than that in the traditional group (P<0.05). Conclusion Transumbilical double-port can complete the pyloromy-otomy under laparoscopic with double-port, and which can get better surgical scars concealment and beauty effects than the traditional double-port, which is worthy of application.
KEYWORDS: congenital hypertrophic pyloric stenosis; laparoscopy; umbilicus; pyloromyotomy

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