经脐旁改良单孔式腹腔镜技术在脑室—腹腔分流术中的临床研究

目的探讨经脐旁改良单孔式腹腔镜技术在脑室-腹腔分流术中的临床价值。 方法回顾性选择钦州市第一人民医院神经外科于2020年1月1日~2021年6月1日收治的脑积水行脑室-腹腔分流术患者60例，其中试验组30例患者行经脐旁改良单孔式腹腔镜技术，对照组30例患者行传统开腹术。记录2组患者术后排气时间、住院时间、手术时间和术后并发症情况，比较2组术前和术后5天疼痛视觉模拟评分法（VAS）评分和疼痛因子指标［包括去甲肾上腺素（NE）、P物质（SP）和前列腺素E₂（PGE₂）］变化。 结果试验组术后排气时间、住院时间和手术时间短于对照组，差异有统计学意义（P＜0.05）。2组术后并发症比较，差异无统计学意义（P＞0.05）。2组术后5天VAS评分低于术前（P＜0.05）；试验组术后5天的VAS评分低于对照组（P＜0.05）。2组术后5天血清NE、SP和PGE₂水平较术前升高（P＜0.05）；试验组术后5天血清NE、SP和PGE₂水平低于对照组（P＜0.05）。 结论经脐旁改良单孔式腹腔镜技术在脑室-腹腔分流术中的临床效果明显，可促进患者快速康复，术后并发症少，且可明显减轻疼痛，抑制疼痛因子释放。

Clinical application of modified transumbilical single port laparoscopic technique in ventriculoperitoneal shunt operation

ObjectiveTo investigate the clinical application of modified transumbilical single port laparoscopic technique in ventriculoperitoneal shunt. MethodsSixty patients with hydrocephalus who underwent ventriculoperitoneal shunt at our hospital from January 1, 2020 to June 1, 2021 were retrospectively selected, of whom 30 underwent the modified transumbilical single port laparoscopic technique (experimental group) and 30 underwent traditional laparotomy (control group). The time to first postoperative exhaust, hospitalization time, operative time, and postoperative complications were recorded in both group. The visual analogue scale (VAS) score and pain factors [including noradrenaline (NE), substance P (SP), and prostaglandin E₂ (PGE₂)] were compared between the two groups before and 5 days after the operation. (NE), substance P (SP) and prostaglandin E₂ (PGE₂)] changed. ResultsThe time to first postoperative exhaust, hospitalization time, and operative time were shorter in the experimental group than in the control group (P＜0.05). At 5 days postoperatively, VAS score was lower than that before the operation in both groups (P＜0.05); VAS score was lower in the experimental group than in the control group (P＜0.05). At 5 days postoperatively, the levels of NE, SP, and PGE₂ were higher than those before the operation in both groups (P＜0.05); the levels of NE, SP, and PGE₂ were lower in the experimental group than in the control group (P＜0.05). ConclusionThe modified transumbilical single port laparoscopic technique has obvious clinical effects in ventriculoperitoneal shunt, which can promote the rapid recovery of patients, significantly reduce pain, and inhibit the release of pain factors, and is associated with fewer postoperative complications.