【摘要】 目的 總結腹腔鏡對小兒美克爾憩室的臨床診斷和應用價值。 方法 2005年4月-2009年12月，將41例行美克爾憩室切除術患兒隨機分為兩孔法腹腔鏡手術組和傳統手術組，就手術治療、術后并發癥、術后效果等臨床資料進行對比分析。 結果 腹腔鏡手術組患兒手術時間、術中出血量、下床活動時間、住院時間等均優于傳統手術組；術后并發癥發生例數均明顯少于傳統手術組。 結論 腹腔鏡對患兒美克爾憩室的診斷和治療具有明顯優越性，可作為小兒美克爾憩室治療的首選方式。【Abstract】 Objective To investigate the diagnostic and applicative value of laparoscopy for Meckel’s diverticulum in children. Methods The clinical data of 41 children with Meckel’s diverticulum who underwent resection between April 2005 to December 2009 were retrospectively analyzed. The patients were divided into tow-port laparoscopy-assisted resection group (group A,19 patients) and traditional resection group (group B, 22 patients). The intra-operative accidental injury, postoperative complications, postoperative general condition and prognosis were evaluated via randomized contrast analysis. Results The time of operation, amount of bleeding, recover intestinal peristalsis,out-of-bed activities time and the average days in hospital in group A were less than those in group B. The postoperative complications occurred in one and eight patients in group A and B respectively. Conclusion Laparoscopy had obvious superiority for the children’s Meckel’ s diverticulum in diagnosis and treatment,which should be the best choice.
Objectives To analyze the efficacy and safety of different operation methods for patients with cesarean scar diverticulum. Methods The clinical data of patients with cesarean section scar diverticulum treated in West China Second University Hospital from July 2012 to December 2016 was collected and followed up. The data of the previous perioperative period data, recovery, the improvement of the symptoms and postoperative condition of incision healing were analyzed by SPSS 22.0 software. Results A total of 125 patients were included, in which 74 cases received hysteroscopy surgery for diverticulum electro section and electric coagulation (ESEC group), and 51 cases received other surgery focused on diverticulum dissection and sewing operations (DS group). Statistical analysis showed that, compared with DS group, bleeding, operation time, time of anal exsufflation and hospitalization duration after the operation of hysteroscopy in ESEC group were significantly reduced (P<0.001). In addition, the results showed that hysteroscopy group had optimal results in hemorrhage volume, operation time, anal exhaust time and hospitalization time indicators. However, the results of laparotomy group was not significant. Conclusions For the treatment of CSD, surgical treatment of this pathology by operative hysteroscopy may represent the best choice in symptomatic women because of its minimal invasiveness and beneficial therapeutic results. Hysteroscopy isthmoplasty appears to be the most popular treatment.
目的:探討MRI不同檢查方法對十二指腸乳頭旁憩室(periampullary diverticulum,PAD)的診斷價值。方法:應用MRI多序列檢查方法診斷PAD23例,并進行分析。結果:T1WI顯示為囊狀低信號影,與十二指腸相通者1例,其余22例表現為不均勻略低及高低混雜信號,均未明確診斷;橫斷位壓脂T2WI顯示含氣液平面囊性病灶15例;冠狀位FIESTA序列表現為混雜高信號或高信號影15例;呼吸觸發3D MRCP表現為高或混雜高信號影16例;冠狀位屏氣3DCE LAVA動態增強掃描均清晰顯示。其中合并膽系結石13例,膽系炎癥及感染13例,胰腺炎3例,膽胰管擴張3例,十二指腸炎癥3例。結論:MRI能多序列、多方位、直觀、無創的清晰顯示PAD的部位、大小、范圍及與鄰近結構的關系,同時顯示膽胰疾病形態學改變。故MRI多序列檢查非常必要,是PAD診斷及鑒別診斷的重要方法。