脐内侧韧带覆盖术在腹腔镜手术治疗小儿腹股沟疝的意义  

Significance of medial umbilical ligament covering in laparoscopic surgery for inguinal hernia in children:A prospective,randomized study

作　　者：卡哈尔·吐尔孙 买买提吐尔逊·吐尔迪[1] 司马依·艾买提 艾尔夏提·依布拉音 克尤木·亚森 吴源泉[1] 克力木·阿不都热依木[2] 

机构地区：[1]喀什地区第一人民医院普外二科,喀什844000 [2]新疆自治区人民医院微创外科、疝和腹壁外科,乌鲁木齐830001

出　　处：《中华疝和腹壁外科杂志（电子版）》2017年第5期340-343,共4页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

基　　金：新疆维吾尔自治区青年科学基金项目(2015Y03)

摘　　要：目的通过前瞻性随机对照试验比较经腹腔镜内环口关闭+脐内侧韧带覆盖术与单纯经腹腔镜内环口关闭术治疗小儿腹股沟疝的疗效。方法自2015年2月至2016年1月,喀什地区第一人民医院住院治疗的小儿腹股沟疝患儿88例,将患儿随机分为2组,每组患儿44例。病例组行腹腔镜内环口关闭术,试验组行腹腔镜内环口关闭+脐内侧韧带覆盖术。结果 2组在手术时间、术中出血量、术区疼痛、术后腹痛、排气障碍、切口感染等方面比较,差异无统计处意义(P>0.05)。术后随访3个月,2组患儿复发率比较,差异无统计学意义(P>0.05)。术后随访6个月及1年,2组患儿复发率比较,差异有统计学意义(P=0.03,0.04)。结论腹腔镜内环口关闭+脐内侧韧带覆盖术较腹腔镜内环口关闭术并不增加手术并发症和术中出血量,不延长手术时间,降低术后复发率。Objective To compare the outcomes of laparoscopic internal ring closure combined with medial umbilical ligament covering and laparoscopic internal ring closure in treatment of children with indirect inguinal hernia. Methods From February 2015 to January 2016,88 children with inguinal hernia admitted to the First People＇ s Hospital of Kashi were randomly divided into two groups（ n = 44 in each group）. The control group underwent laparoscopic internal ring closure operation,while test group underwent laparoscopic ring closure combined with medial umbilical ligament covering operation. Results There were no significant differences between the two groups in the operation time, intraoperative bleeding, and complication of postoperative pain,abdominal pain,exhaust obstruction,incision infection（P〈0. 05）. As to inguinal hernia recurrence rate,there was no significant difference between the two groups after 3 months of follow-up,and it showed statistically significant after 6 months follow-up（ P = 0. 03） and one year followup period（ P = 0. 04）. Conclusion Compared with laparoscopic internal ring closure,laparoscopic internal ring closure combined with umbilical medial ligament covering does not increase operation time,postoperative complications,and intraoperative bleeding loss. Meanwhile, the postoperative recurrence rate can be reduced.

关 键 词：疝 腹股沟 腹腔镜 儿童 

分 类 号：R726.5[医药卫生—儿科]