婴儿年龄对胆道闭锁腹腔镜手术影响分析.docVIP

婴儿年龄对胆道闭锁腹腔镜手术影响分析 　　【摘要】 目的：探讨胆道闭锁患儿年龄对腹腔镜Kasai手术的影响。方法：回顾性分析2010年1月-2015年1月深圳市儿童医院经腹腔镜Kasai手术治疗的胆道闭锁患儿共72例。根据患儿手术时日龄将其分为两组，其中患儿手术日龄≤45 d为研究组25例，手术日龄45 d为对照组47例，比较两组的手术时间、术中出血量、手术气腹压、中转开放率、术后转入PICU病房率等。结果：研究组平均手术时间及术中出血量比对照组多，两组比较差异有统计学意义（P0.05）。结论：对于年龄较小的胆道闭锁患儿，腹腔镜Kasai术手术难度及手术风险更大，术中需更加谨慎。 　　【关键词】 胆道闭锁； 腹腔镜； Kasai手术 　　Analysis of the Influence of Age on Biliary Atresia Infant Laparoscopic Operation/WU Zhou-guang，WANG Jian-yao，WANG Bin，et al.//Medical Innovation of China，2015，12（24）：008-011 　　【Abstract】 Objective：To explore the effect of age on biliary atresia children of laparoscopic Kasai operation. Method： 72 children with biliary atresia after laparoscopic Kasai operation from January 2010 to January 2015 in Shenzhen childrens Hospital for were be retrospective analysised.According the operation time of children age，they were divided into two groups，the study group of 25 cases were operation on children with age less than 45 days and the control group of 47 cases were operation days of age45 days.The average operation time，intraoperative bleeding volume， operation pressure of pneumoperitoneum， conversion to open rate and postoperative transfer into PICU ward rate of two groups were compared.Result：The average operation time amount and intraoperative bleeding volume were more than control group，the differences were statistically significant（P0.05）.Conclusion：For younger patients with biliary atresia， laparoscopic Kasai surgery is difficulty and has higher risk in the operation，it need be more careful. 　　【Key words】 Biliary atresia； Laparoscopy； Kasai operation 　　First-author’s address：Children’s Hospital of Shenzhen，Shenzhen 518026，China 　　doi：10.3969/j.issn.1674-4985.2015.24.003 　　胆道闭锁（Biliary atresia，BA）是儿童最常见的严重肝脏疾病，以肝内和肝外胆管进行性炎症和纤维性梗阻为特征，从而导致胆汁排泄障碍以及进行性的肝纤维化，最终因肝衰竭而死亡[1]。Kasai手术是当前治疗胆道闭锁的首要手段，随着微创外科技术的发展，腹腔镜Kasai手术的报道越来越多，胆道闭锁的腹腔镜手术以其微创及精准的解剖视野优势，已逐渐受学界所重视[2-3]。有研究表明，手术年龄越少，Kasai手术的预后可能相对越好[4-5]。但年龄较少的婴儿接受腹腔镜手术，目前仍然存在一定的争议[6]。因此，有必要对小婴儿的胆道闭锁腹腔镜手术进行