腹腔镜下雪橇针治疗婴幼儿巨大疝的应用体会  

Clinical experience of laparoscopic hernia repair with sledge-shaped needle for huge hernia in children

作　　者：夏东亮[1] 张丽华[1] 李庆浩[1] 张凯[1] 张其海[1] 

机构地区：[1]泰安市中心医院儿童外科,山东省271000

出　　处：《中华疝和腹壁外科杂志（电子版）》2015年第1期51-53,共3页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

摘　　要：目的探讨腹腔镜下雪橇针单次腹壁穿刺和疝囊超高位结扎治疗婴幼儿巨大疝的可行性和临床疗效。方法回顾性分析2012年1月至2014年1月,泰安市中心医院收治68例儿童腹股沟疝患儿,行腹腔镜经皮穿刺腹膜外结扎术（LPEC）治疗,采用普通雪橇针带双线单次腹壁穿刺和疝囊超高位结扎的技术方法。观察手术时间、出血量、住院时间以及术后随访情况。结果本组68例患儿全部完成LPEC手术,手术时间25-50 min,平均（35±13）min;术中出血1-5 ml,平均（1.5±1.0）ml;术后住院时间1-4 d,平均（3.0±0.8）d。术后随访6-18个月,未发现复发及术后鞘膜积液率,睾丸轻度上升1例。结论雪橇针单次腹壁穿刺和疝囊超高位结扎治疗婴幼儿巨大疝方法简易可行,治疗效果良好。Objective To investigate the feasibility and clinical efficacy of sledge-shaped needle in laparoscopic hernia sac high ligation with single abdominal puncture to treat infant huge hernia. Methods A total of 68 cases of inguinal hernia in children who underwent laparoscopic percutaneous extraperitoneal closure（ LPEC） in Tai＇ an Central Hospital from January 2012 to January 2014 were enrolled in this respective study. In the operations,single abdominal puncture with sledge-shaped needle（ with double sutures） and hernia sac super-high ligation were performed. The children were observed with operating time,blood loss, length of hospitalization stay, and postoperative follow-up. Results The LPEC were successfully completed in all patients. The operating time was 25 to 50 minutes, mean of（ 35 ±13） minutes; intraoperative blood loss was 1 to 5 ml,mean of（ 1. 5 ± 1. 0） ml; postoperative length of stay was 1 to 4 days,（ 3. 0 ± 0. 8） days on average. Only a case of mild ascending testis occurred,there was no recurrence or hydrocele during follow-up（ 6 to 18 months）. Conclusion Single abdominal puncture with sledge-shaped needle and hernia sac super-high ligation technique are feasible,easy to handle,and having good clinical outcomes for huge inguinal hernia in children.

关 键 词：疝 腹股沟 腹腔镜 疝修补术 儿童 

分 类 号：R726.5[医药卫生—儿科]