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[儿童纽扣式胃造口术]

[Button gastrostomy in children].

作者信息

Kozlov Iu A, Novozhilov V A, Rasputin A A, Us G P, Kuznetsova N N

机构信息

Tsentr khirurgii i reanimatsii novorozhdennykh Gorodskoĭ Ivano-Matreninskoĭ detskoĭ klinicheskoĭ bol'nitsy, Irkutsk; Kafedra detskoĭ khirurgii Irkutskoĭ gosudarstvennoĭ meditsinskoĭ akademii poslediplomnogo obrazovaniia.

Tsentr khirurgii i reanimatsii novorozhdennykh Gorodskoĭ Ivano-Matreninskoĭ detskoĭ klinicheskoĭ bol'nitsy, Irkutsk; Kafedra detskoĭ khirurgii Irkutskogo gosudarstvennogo meditsinskogo universiteta; Kafedra detskoĭ khirurgii Irkutskoĭ gosudarstvennoĭ meditsinskoĭ akademii poslediplomnogo obrazovaniia.

出版信息

Khirurgiia (Mosk). 2015(1):48-53. doi: 10.17116/hirurgia2015148-53.

Abstract

For the period January 2002 to December 2013 it was performed 84 interventions for introduction of gastrostomy tube. The first group included 24 open operations and the second group had 60 laparoscopic operations by using of button devices MIC-KEY (Kimberly-Clark, Roswell, USA) in neonates and infants. Statistically significant difference was not observed during comparison of demographic data of patients. Differences in groups were found in statistical analysis of intra- and postoperative parameters (p<0.05). Mean duration of surgery in the first group was 37.29 min, in the second group - 23.97 min. Time to start of feeding and transition to complete enteral nutrition was less in patients who underwent laparoscopic surgery than after open intervention (10.5 and 19.13 hours, 23.79 and 35.88 hours respectively; p<0.05). It was revealed augmentation of hospital stay in the 1st group in comparison with the 2(nd) group (11.71 and 7.09 days respectively; p<0.05). Frequency of postoperative complications was 18.33% in the 2(nd) group and 24% - in the 1st group (p<0.05). The authors consider that button devices are simply and effective technique of gastrostomy establishment in children. It is associated with minimal surgery duration and allows to start early enteral nutrition in comparison with open techniques.

摘要

在2002年1月至2013年12月期间,共进行了84次胃造口管置入干预。第一组包括24例开放手术,第二组对新生儿和婴儿采用美国罗森韦尔金佰利公司生产的MIC-KEY纽扣装置进行了60例腹腔镜手术。在比较患者的人口统计学数据时未观察到统计学上的显著差异。在对术中及术后参数进行统计分析时发现两组存在差异(p<0.05)。第一组的平均手术时间为37.29分钟,第二组为23.97分钟。接受腹腔镜手术的患者开始喂养和过渡到完全肠内营养的时间比开放干预后要短(分别为10.5和19.13小时,23.79和35.88小时;p<0.05)。结果显示,第一组的住院时间比第二组长(分别为11.71天和7.09天;p<0.05)。第二组术后并发症发生率为18.33%,第一组为24%(p<0.05)。作者认为,纽扣装置是一种简单有效的儿童胃造口术建立技术。与开放技术相比,它手术时间最短,并能尽早开始肠内营养。

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