文档介绍：上海交通大学
硕士学位论文
先天性肥厚性幽门狭窄的规范治疗初步探讨
姓名:龚一鸣
申请学位级别:硕士
专业:临床医学儿科学(普外)
指导教师:蔡威
20080504
01 级七年制硕士研究生论文
先天性肥厚性幽门狭窄的规范治疗初步探讨

摘要

目的: 比较、分析先天性肥厚性幽门狭窄患儿在不同手术方式及不
同围手术期处理策略下的临床结果,试图探索合理、规范的治疗方案。
方法: 回顾分析上海市两家儿童医疗中心1992~2007年间CHPS患儿
的临床病例;根据手术方式分为普通手术组和腹腔镜组;根据术后喂养
时间分为早喂养组(<12hr)、较早喂养组(12~24hr)和晚喂养组(>24hr),
比较临床结果。统计分析采用SAS 。
结果:共计230例CHPS患儿(男200例,女30例),平均入院日龄为46
±22天(10~118天), 平均的出现呕吐至入院天数为25±20天,平均入
院体重为3843±774克。腹腔镜手术组与普通手术组手术时间相似,达全
量喂养时间、住院天数和术后住院天数显著缩短(P<),住院费用
显著增加;而并发症、呕吐致喂养方案改变的发生率及体重增长无明显
差异。12小时内喂养组与其他组比较,住院天数、达全量喂养时间、呕
吐致喂养方案改变的发生率及体重增长等均无明显差异。
结论: CHPS施行腹腔镜手术,达全量喂养及住院天数、术后住院天
数显著缩短,但费用显著增加。进行早期喂养有助于改善临床结果。术
后12h内早期喂养是安全的。

关键词先天性肥厚性幽门狭窄,腹腔镜手术,肠内喂养
01 级七年制硕士研究生论文
A STUDY OF NORM TREATMENT
FOR CONGENITAL HYPERTROPHIC
PYLORIC STENOSIS

ABSTRACT

Objective: To analyze the clinical es of the CHPS patients with different
operation and feeding strategy.
Method: A retrospective study was conducted in two children’s hospitals. Due to
different feeding time after sugery, we divided all the patients into late feeding
group(>24hr),early feeding group(within 12-24hr) and earlier feeding group(<12hr).
According to different types of operation, patients were divided into general group and
laparoscopy group. Their clinical es pared. Statistical analyses were
performed by using SAS (Version ) software.
Results:Totally 230 patients were involved, including 200 males and 30 females with
a mean age of 46±22 days and weight of 3843±774g. More closer to nowadays, the
proportion of laparoscopic surgery and early feeding were higher, the length of hospital
stay was shorter and hospital cost was lesser. Time to full feeding, length of hospital stay
and hospital stay after operation were lesser in laparoscopy group than general, but the
cost was significant higher. There were no significant differences in the operation time,
incidences plications, continuous vomiting, feed