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目的:探讨腹腔镜在小儿肠套叠复位术中的应用价值。方法:对2004-02/2008-08本院收治的空气灌肠复位失败的肠套叠患儿20例采用腹腔镜手术治疗。结果:15例手术顺利,肠套叠复位,5例复位失败中转开腹手术,1例腹腔镜探查发现憩室而行开腹手术。肠系膜淋巴结活检6例,平均手术时间约100 min。术后24 h肠鸣音恢复,住院时间4~7 d,出院后随访2~38个月,患儿恢复良好无伤口感染、肠套叠复发及肠粘连梗阻等并发症发生。结论:在严格掌握腹腔镜手术的适应证及禁忌证的状况下,对空气灌肠复位失败的难复性小儿肠套叠,腹腔镜手术是一种安全有效的微创治疗方法。
Objective: To investigate the value of laparoscopy in children with intussusception. Methods: Twenty cases of intussusception patients who failed to restore air enema admitted to our hospital from February 2004 to August 2008 were treated with laparoscopy. Results: The operation was successful in 15 cases, the intussusception was reset, and 5 cases failed to be converted to laparotomy. One case of laparoscopic exploration revealed diverticulum undergoing laparotomy. Mesenteric lymph node biopsy in 6 cases, the average operation time of about 100 min. The bowel sounds recovered at 24 hours after operation, and the hospitalization time was 4 to 7 days. The patients were followed up for 2 to 38 months after discharge. The children recovered well without wound infection, and complications such as intussusception and intestinal adhesion obstruction occurred. Conclusions: With strict indications of laparoscopic indications and contraindications, it is a safe and effective minimally invasive treatment for refractory children with intussusception and laparoscopic surgery.