两种不同方式单孔法、腔镜下鞘状突高位结扎术的比较  

Comparative analysis of two different single orifice laparoscopic surgeries for patent processus vaginalis

作　　者：吴尔岸 银河[1] 廖林楚[1] 何庆华[1] 张然昆[1] 莫钢[1] 

机构地区：[1]广西科技大学第一附属医院泌尿外科,广西壮族自治区柳州市545002

出　　处：《中国综合临床》2016年第7期581-584,共4页Clinical Medicine of China

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费课题（Z2015059）

摘　　要：目的：评价两种不同方式单孔法、腔镜下鞘状突高位结扎术治疗小儿交通性精索鞘膜积液的临床效果。方法2013年8月至2015年6月我们共收治84例交通性精索鞘膜积液患儿，按随机数字表法分为两组，42例应用普通微型腹腔镜、单切口、双通道法（微型腹腔镜组），42例应用李逊肾镜、单切口、单通道法（李逊肾镜组），两组均在腔镜监视下带线器、辅助钳辅助下完成对鞘状突高位结扎。比较两组患儿的平均单侧手术时间、平均术后住院时间、并发症和复发率。结果两组手术均顺利完成，无中转开放手术，平均单侧手术时间微型腹腔镜组为（12．53±3．22） min，李逊肾镜组为（10．16±2．79） min，差异有统计学意义（P＝0．037）；平均术后住院时间微型腹腔镜组组为（2．29±0．57） d，李逊肾镜组为（2．25±0．55） d，差异无统计学意义（P＝0．671）。两组术后随访均无并发症发生，均未见复发。结论单切口、单通道、李逊肾镜经皮穿刺腹膜外内环口结扎术安全、有效，而且较常规腹腔镜手术更加便捷、微创。Objective To investigate the clinical efficacy of two different single orifice laparoscopic surgeries for patent processus vaginalis in children. Methods From August 2013 to June 2015,there were 84 children with patent processus vaginalis in the First Affiliated Hospital of Guangxi University of Science and Technolgy. They were divided into two groups （ A and B ） randomly according to different laparoscopic surgeries. Group A：used ordinary micro-laparoscope, single orifice, and double channel. Group B：used Li Xun nephroscope,single orifice,single channel. Both two groups′ the high ligation of the sheath was performed with the aid of the auxiliary forceps in the mirror under surveillance. The mean unilateral operation time, mean postoperative hospitalization duration,complications and recurrences of two groups were compared. Results All children underwent successful laparoscopic surgery,without transfering to open surgery,and unilateral operation time was （12. 53±3. 22） min for group A,（10. 16±2. 79） min for group B,the difference was significant（P=0. 037）. The mean postoperative hospitalization duration was （2. 29±0. 57） d in group A,（2. 25±0. 55） d in group B, the difference was not significant （ P= 0. 671 ） . There was no complication and recurrence in two groups. Conclusion laparoscopic percutaneous extraperitoneal closure use Li Xun nephroscope,single orifice, single channel for children is safe and effective,and it is more convenient and less invasive than the conventional micro-laparoscope.

关 键 词：鞘膜积液 腹腔镜 李逊肾镜 

分 类 号：R726.972.3[医药卫生—儿科]