腹腔镜疝囊高位结扎加脐正中襞修补手术在小儿腹股沟斜疝中的应用  

Application of Laparoscopic High Ligation of Hernia Sac and Median Umbilical Fold in Surgical Repair of Inguinal Hernia in Children

作　　者：周晓波[1] 段永福[1] 赵成鹏[1] 李付奎[1] 

机构地区：[1]河南省南阳市中心医院小儿外科,南阳473000

出　　处：《中国微创外科杂志》2016年第12期1121-1124,共4页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨腹腔镜疝囊高位结扎加脐正中襞修补手术在小儿腹股沟斜疝中的应用价值。方法 2013年8月-2014年8月对小儿腹股沟斜疝322例行腹腔镜疝囊高位结扎术,不同术者采取不同手术方案,其中联合脐正中襞修补168例（A组）,未联合154例（B组）,对2组的临床资料进行比较分析。结果发现对侧隐匿疝A组21例,B组16例,均同期处理。2组在手术时间[（26.9±7.6）min vs.（25.9±8.1）min,t=1.097,P=0.273],术后疼痛视觉模拟评分[（22.6±8.0）分vs.（22.4±8.0）分,t=0.179,P=0.858],术后住院时间[（2.9±1.3）d vs.（2.8±1.6）d,t=0.502,P=0.616],术后并发症发生率[2.4%（4/168）vs.4.5%（7/154）,χ^2=1.141,P=0.285]方面均无统计学差异。术后随访1年,A组未见复发,B组8例术侧复发,A组复发率低于B组[0（0/168）vs.5.2%（8/154）,P=0.002]。结论腹腔镜加脐正中襞自体组织修补手术能有效降低小儿腹股沟斜疝的复发率,值得临床推广。Objective To investigate the clinical value of laparoscopic high ligation combined with autologous tissue repair for indirect inguinal hernia in children. Methods We selected 322 in-hospital cases of pediatric indirect inguinal hernia as the objects of study from August 2013 to August 2014 in our department. According to different surgical options performed by different doctors,the patients were divided into 2 groups： laparoscopic and autologous tissue repair group（ group A,n = 168） or laparoscopic group（ group B,n = 154）. The clinical data of the two groups were compared and analyzed. Results In this study,we found contra-lateral occult hernia in 21 patients in the group A and 16 patients in the group B. No statistical differences were found in the operation time[（ 26. 9 ± 7. 6） min vs.（ 25. 9 ± 8. 1） min,t = 1. 097,P = 0. 273],postoperative visual analogue scale（ VAS） score [（ 22. 6 ± 8. 0）points vs.（ 22. 4 ± 8. 0） points,t = 0. 179,P = 0. 858],postoperative hospital stay [（ 2. 9 ± 1. 3） d vs.（ 2. 8 ± 1. 6） d,t = 0. 502,P = 0. 616],and postoperative complications [2. 4%（ 4 /168） vs. 4. 5%（ 7 /154）,χ^2= 1. 141,P = 0. 285] between the group A and the group B. In one year of follow-up,there was no recurrence in the group A and 8 cases of recurrence in the group B,the recurrence rate being significantly lower in the group A than the group B [0（ 0 /168） vs. 5. 2%（ 8 /154）,P = 0. 002]. Conclusion Laparoscopy combined with autologous tissue repair surgery can effectively reduce the rate of recurrence of indirect inguinal hernia in children,being worthy of clinical popularization.

关 键 词：腹腔镜疝囊高位结扎术 脐正中襞 自体组织修补 小儿 腹股沟斜疝 

分 类 号：R726.5[医药卫生—儿科]