Congenital diaphragmatic eventration, Thoracoscopic diaphragm plication, Hernia needle,Infant
,"/> <span style="font-size:14px;line-height:2;">疝气针辅助胸腔镜下膈肌折叠术治疗</span><span style="font-size:14px;line-height:2;">先天性膈膨升的效果分析</span>
Please wait a minute...
欢迎访问发育医学电子杂志,今天是
发育医学电子杂志  2025, Vol. 13 Issue (4): 276-281    DOI: 10.3969/j.issn.2095-5340.2025.04.005
  结构畸形   论著 |
疝气针辅助胸腔镜下膈肌折叠术治疗先天性膈膨升的效果分析
李广 张艳平 刘钢 田静 曹剑英 谢华伟 段炼 徐翠 张珊
(解放军总医院儿科医学部 解放军总医院第七医学中心 儿科研究所 出生缺陷防控关键技术国家工程实验室 儿童器官功能衰竭北京市重点实验室,北京 100700)
Analysis of the effect of hernia needle-assisted thoracoscopic diaphragm plication in the treatment of congenital diaphragm eventration
Li Guang, Zhang Yanping, Liu Gang, et al
(Beijing Key Laboratory of Pediatric Organ Failure, National Engineering Laboratory for Birth Defects Prevention and Control of Key Technology, Institute of Pediatrics, the Seventh Medical Center of Chinese PLA General Hospital, Faculty of Pediatrics, Chinese PLA General Hospital, Beijing 100700, China)
下载:  PDF (1044KB) 
输出:  BibTeX | EndNote (RIS)      
摘要 【摘要】 目的  探讨疝气针辅助胸腔镜下膈肌折叠术治疗先天性膈膨升的疗效。 方法 选取 2015 年1月至 2024 年 7 月在解放军总医院第七医学中心诊断为先天性膈膨升并行胸腔镜下膈肌折叠术的患儿 40 例,按照随机数字表法将其分为研究组和对照组,每组各 20 例。研究组患儿采用疝气针辅助胸腔镜下膈肌折叠术,对照组患儿采用传统胸腔镜下膈肌折叠术。比较 2 组患儿的术中出血量、切口长度、手术时间、术后机械通气时间、拔出胸腔引流管时间、术后进食时间、住院时间、术后复发率和生存率。
统计学方法采用独立样本 t 检验、χ2 检验。 结果  研究组与对照组患儿的性别、胎龄、出生体质量以及发病部位比较,差异均无统计学意义(P 值均 >0.05)。研究组的术中出血量少于对照组 [(2.12±0.41)ml与(3.02±0.56)ml,t=-5.012,P=0.002] ;切口长度 [(1.59±0.39)cm 与(2.77±0.42)cm,t=-6.474,P=0.015]、手术时间 [(79.91±10.15)min 与(93.22±7.84)min,t=-3.279,P=0.023]、术后机械通气时间 [(1.32±0.32)d与(1.64±0.67)d,t=-5.186,P=0.044]、术 后 进 食 时 间 [(1.61±0.29)d 与(1.95±0.27)d,t=-2.762,P=0.032]、拔 出 胸 腔 引 流 管 时 间 [(3.08±0.50) d 与(3.21±0.44) d,t=-3.615,P=0.019]、住 院 时 间[(12.80±0.33) d 与(16.12±0.47)d,t=-3.328,P=0.044] 均短于对照组,差异均有统计学意义。术后,研究组 20 例均治愈出院,随访均未见复发,但 1 例出院后随访 1 个月,因发生败血症而死亡;对照组 20 例均
治愈出院,随访中术后 4 个月复发 2 例。两组的复发率比较,差异无统计学意义(P>0.05)。 结论 疝气针辅助胸腔镜下膈肌折叠术治疗先天性膈膨升手术创伤小,可减少术中出血量,缩短手术时间及住院时间,且安全、有效,达到了手术预期的优势,值得推广。
服务
把本文推荐给朋友
加入引用管理器
E-mail Alert
RSS
作者相关文章
关键词:  先天性膈膨升  胸腔镜膈肌折叠术  疝气针  婴幼儿    
Abstract: 【Abstract】 Objective To explore the efficacy of hernia needle-assisted thoracoscopic diaphragmatic plication in the treatment of congenital diaphragmatic eventration. Method A total of 40 children diagnosed with diaphragmatic eventration and undergoing diaphragmatic plication at the Seventh Medical Center of Chinese PLA General Hospital from January 2015 to July 2024 were selected as study subjects. They were randomly divided into the study group and the control group according to the random numbertable method, with 20 cases in each group. The study group received hernia needle-assisted thoracoscopic diaphragmatic plication, while the control group underwent traditional thoracoscopic diaphragmatic plication. 
The following parameters were compared between the two groups: intraoperative blood loss, incision length, operative time, postoperative mechanical ventilation duration, time for removing the thoracic drainage tube, postoperative feeding time, hospital stay, postoperative recurrence rate, and survival rate. Statistical analysis was performed by independent samples t-test, χ2test. Result There were no statistically significant differences in gender, gestational age, birth weight, and lesion site between the infants in the study group and the control group (all P>0.05). The intraoperative blood loss in the study group was less than that in the control group [(2.12±0.41) ml vs (3.02±0.56) ml, t=-5.012, P=0.002]. The incision length [(1.59±0.39) cm vs (2.77±0.42) cm, t=-6.474, P=0.015], operation time [(79.91±10.15) min vs (93.22±7.84) min, t=-3.279, P=0.023], postoperative mechanical ventilation time [(1.32±0.32) d vs (1.64±0.67) d, t=-5.186, P=0.044], postoperative feeding time [(1.61±0.29) d vs (1.95±0.27) d, t=-2.762, P=0.032], time for removing the thoracic drainage tube [(3.08±0.50) d vs (3.21±0.44) d, t=-3.615, P=0.019], and hospital stay [(12.80±0.33) dvs (16.12±0.47) d, t=-3.328, P=0.044] in the study group were all shorter than those in the control group, with statistically significant differences. After surgery, all 20 cases in the study group were cured and discharged, and no recurrence was found during follow-up. However, 1 case died of sepsis 1 month after 
discharge during follow-up. All 20 cases in the control group were cured and discharged, and 2 cases recurred 4 months after surgery during follow-up. There was no statistically significant difference in the recurrence rate between the two groups (P>0.05). Conclusion Hernia needle-assisted thoracoscopic diaphragmatic plication for treating congenital diaphragmatic eventration demonstrates minimal surgical trauma, reduces blood loss, shortens both operative time and hospital stay, and proves to be safe and effective. This technique achieves the anticipated surgical advantages and is worthy of clinical promotion.

Key words:  Congenital diaphragmatic eventration')" href="#">Congenital diaphragmatic eventration    Thoracoscopic diaphragm plication    Hernia needle    Infant
')" href="#">Infant
收稿日期:  2024-12-02                     发布日期:  2025-07-31     
基金资助: 军队计生专项科研课题(21JSZ18)
通讯作者:  张珊    E-mail:  zhangs6349@163.com
引用本文:    
李广 张艳平 刘钢 田静 曹剑英 谢华伟 段炼 徐翠 张珊. 疝气针辅助胸腔镜下膈肌折叠术治疗先天性膈膨升的效果分析[J]. 发育医学电子杂志, 2025, 13(4): 276-281.
Li Guang, Zhang Yanping, Liu Gang, et al. Analysis of the effect of hernia needle-assisted thoracoscopic diaphragm plication in the treatment of congenital diaphragm eventration. Journal of Developmental Medicine(Electronic Version), 2025, 13(4): 276-281.
链接本文:  
http://www.fyyxzz.com/CN/10.3969/j.issn.2095-5340.2025.04.005  或          http://www.fyyxzz.com/CN/Y2025/V13/I4/276
[1] 高鹏 吕秋晨 杨狄 张为伟 李志强. 完全植入式静脉输液港在婴幼儿白血病患儿中的应用[J]. 发育医学电子杂志, 2025, 13(4): 287-292.
[2] 张楚轩 江敏. 产后抑郁症对婴幼儿发育影响的研究进展[J]. 发育医学电子杂志, 2025, 13(3): 219-224.
[3] 汪永娟 王超霞 王艳霞 马先生. 山东省沂蒙农村地区8 ~ 16 月龄婴幼儿语言理解水平调查研究[J]. 发育医学电子杂志, 2024, 12(6): 445-450.
[4] 石素宁  宗晶  刘莉  陈慧敏 戴晓婧. 婴幼儿热射病的防控策略[J]. 发育医学电子杂志, 2022, 10(6): 477-480.
[5] 张强 吕延宝 单玲 杜琳. 踝足矫形器在痉挛型脑性瘫痪儿童中的应用研究进展[J]. 发育医学电子杂志, 2022, 10(1): 70-74.
[6] 杜航 张奥丹 杨书龙 张泽楠 李昭铸. 小儿胆总管囊肿的手术治疗及并发症处理[J]. 发育医学电子杂志, 2022, 10(1): 75-80.
[7] 蒋维维 唐维兵.
婴幼儿肠衰竭的治疗现状与展望
[J]. 发育医学电子杂志, 2020, 8(3): 198-204.
[8] 熊永红 胡莉 严树涓 等 . PRRT2 相关发作性疾病家系致病基因的突变研究[J]. 发育医学电子杂志, 2019, 7(2): 136-140.
[9] 余莉华 林丹娜 巫一立 王小兰 吴莉 胡秋磊 王斌 杨丽华. 婴幼儿Kasabach-Merritt综合征8例临床研究[J]. 发育医学电子杂志, 2018, 6(2): 86-90.
[10] 花少栋 梅亚波. 儿童昏迷的诊治进展   [J]. 发育医学电子杂志, 2018, 6(2): 125-128.
[11] 祝彬 许煊. 婴幼儿先天性胆总管囊肿自发穿孔1例[J]. 发育医学电子杂志, 2017, 5(2): 110-111.
[12] 刘宇航 文平 朱全伟 等. 低龄低体重先天性心脏病患儿实施经胸微创介入术的临床研究[J]. 发育医学电子杂志, 2016, 4(3): 144-148.
[13] 王刚 周更须 殷秀 等. 围术期综合措施预防婴幼儿心脏手术切口感染的研究[J]. 发育医学电子杂志, 2016, 4(3): 162-165.
[14] 余治奇 蒋罗 于生友 于力. 环磷酰胺联合泼尼松治疗婴幼儿肾病综合征的疗效评价[J]. 发育医学电子杂志, 2015, 3(3): 156-159.
No Suggested Reading articles found!
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed