腹腔镜与小切口腹股沟疝手术的疗效比较  

The clinical studies of Laparoscopic or small incision in the groin hernia surgery

作　　者：敬鹏[1] 邹家琼[2] 张均[2] 刘素兰[2] 蒋兴亮[2] 王城[1] 

机构地区：[1]川北医学院附属医院小儿外科,四川省南充市637000 [2]川北医学院附属医院检验科,四川省南充市637000

出　　处：《临床小儿外科杂志》2014年第1期13-15,33,共4页Journal of Clinical Pediatric Surgery

摘　　要：目的 比较腹腔镜与小切口手术方式在治疗小儿腹股沟斜疝中的优缺点.方法 将180例临床确诊为单侧腹股沟斜疝的患儿,随机分为腹腔镜手术组和小切口手术组,每组各90例.腹腔镜手术组采用腹腔镜辅助下内外结合腹膜外疝囊高位环扎术;小切口手术组采用下腹小横切口行疝囊高位结扎术.通过对腹腔镜手术组及小切口手术组在手术时间、术后恢复情况等方面的比较来评价两种手术方式的优缺点.同时在术后3d及半年后对手术患儿进行门诊随访,以了解两种术式的预后情况.结果 腹腔镜手术组患儿手术时间较小切口手术组短,差异有统计学意义（P＜0.05）,且在3岁以下年龄段比较中差异显著（P＜0.05）;组内比较中,小切口手术组3岁以上年龄段患儿手术时间较3岁以下患儿短（P＜0.05）,而腹腔镜手术组组内对比差异无统计学意义（P＞0.05）.两组麻醉清醒时间比较,差异无统计学意义,短期恢复进食后,腹腔镜手术组不良反应的发生率较小切口手术组高.术后短期随访发现小切口手术组阴囊肿胀的发生率高于腹腔镜手术组.而半年后随访,小切口手术组8例出现对侧腹股沟斜疝,腹腔镜手术组未发现对侧疝.结论 两种手术方法均能有效治疗小儿腹股沟斜疝,腹腔镜手术时间短、损伤小,恢复较小切口手术佳,可发现对侧隐性疝;但操作技术及器械要求较高,手术开展有一定的局限性.Objetive To compare the advantages and disadvantages of laparoscopic or small incision in the pediatric inguinal hernia.Methods The 180 patients diagnosed with unilateral inguinal hernia in children,were randomly divided into two groups of laparoscopic group and small-incision group,90 cases in each group.The laparoscopic group with laparoscopic-assisted combination of internal and external hernia sac high cerclage in extraperitoneal; small incision surgery group were lower abdominal small transveree incision line hernia sac high ligation.Comprehensive evaluation the advantages and disadvantages of two surgical ways by Operative time,postoperative recovery project.At the same time in three days after surgery and six months after surgery in children with out-patient follow-up in order to know the prognosis of the two procedures.Results Laparoscopic group were smaller operation time than short incision group was statistically significant （P ＜ 0.05）,and in less than three years old age the comparison significant difference （P ＜ 0.05） ; Group comparisons,a small incision in the age group over three children operative time shorter than three years of age in children （P ＜ 0.05）,the contrast was not statistically significant （P ＞ 0.05） in the laparoscopic group.The anesthesia awake time was no significant difference in the two groups,after short-term recovery eating,laparoscopic group was incidence of adverse reactions smaller incision group.The short-term follow-up after surgery found that scrotal swelling in children small-incision group was higher than in the laparoscopic group.After six months follow-up,eight cases appeared groin heraia on the other side in children with small-incision group.Laparoscopic group no recurrence.Conclusion The two surgical methods could effective treatment of children with inguinal hernia.Laparoscopic surgery had short time,less damage,restore better than smaller incision group,and long-term recurrence rate is low;Laparoscopic operative techniques and equipment re

关 键 词：腹腔镜 疝 腹股沟 外科手术 

分 类 号：R779.66[医药卫生—眼科]