传统及腹腔镜手术治疗小儿嵌顿疝的疗效  

Comparison of clinical efficacy of laparoscopy and traditional surgery for children with incarcerated indirect inguinal hernia

作　　者：汪岩 王明考 孙枭雄 张晓雨 赵海剑 Wang Yan;Wang Mingkao;Sun Xiaoxiong;Zhang Xiaoyu;Zhao Haijian(Department of Gastrointestinal Surgery, Huaian Hospital Affiliated to Xuzhou Medical University, Jiangsu,Huaian 223002, China)

机构地区：[1]徐州医科大学附属淮安医院胃肠外科

出　　处：《中华疝和腹壁外科杂志（电子版）》2019年第5期440-443,共4页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

摘　　要：目的探讨传统或腹腔镜手术治疗小儿嵌顿性腹股沟斜疝的疗效。方法选取2012年1月至2017年3月,徐州医科大学附属淮安医院收治的嵌顿性腹股沟斜疝患儿80例,根据治疗方式不同,分为试验组及对照组,每组患儿40例。试验组采用腹腔镜手术治疗,对照组采用传统手术治疗,比较2组患儿的临床疗效。结果试验组患儿的切口长度、住院时间及术后首次排气时间分别为(0.8±0.2)cm、(7.6±1.4)d、(6.6±1.3)h均显著优于对照组(3.8±1.0)cm、(14.6±2.1)d、(12.3±2.0)h,差异有统计学意义(t=-18.605、-17.541、-15.113,P均<0.001);试验组患儿手术时间(26.5±8.0)min与对照组(25.8±7.3)min比较,差异无统计学意义(t=0.409,P=0.684);试验组患儿的术后并发症率(2.5%)显著低于对照组患儿(22.5%),差异有统计学意义(χ^2=7.314,P=0.007);试验组治疗后3d的IgG、IgA、IgM、CPR、IL-6免疫炎性指标与治疗前比较,差异有统计学意义(t=8.232、15.787、13.416、-25.612、-37.547,P均<0.001);对照组治疗后3d的IgG、IgA、IgM、CPR、IL-6免疫炎性指标与治疗前比较,差异有统计学意义(t=3.943、16.971、8.000、-12.580、-17.545,P均<0.001);治疗后3d试验组患儿的IgG、IgA、IgM、CPR、IL-6免疫炎性指标均较对照组明显改善,差异均有统计学意义(t=-3.526、-8.485、-5.262、13.091、20.155,P均<0.001);试验组术后1年复发率为0,对照组为5%,差异无统计学意义(χ^2=0.513,P=0.474)。结论腹腔镜治疗小儿嵌顿性腹股沟斜疝的疗效显著,同时可减轻术后短期免疫应激反应,但针对其预后情况,需进一步加大例数深入研究。Objective To investigate the comparison of clinical efficacy of laparoscopy and traditional surgery for children with incarcerated indirect inguinal hernia. Methods From January 2012 to March 2017, 80 children with incarcerated indirect inguinal hernia admitted to Huaian Hospital Affiliated to Xuzhou Medical University were divided into study group and control group according to different treatment methods, with 40 cases in each group. Patients in the control group were given traditional surgery and patients in the study group were given laparoscopy surgery, then the clinical outcome of two groups were compare. Results The length of incision, the time of hospitalization and first farting in the study group were better than those in the control group [(0.8±0.2) cm vs (3.8±1.0) cm,(7.6±1.4) days vs (14.6±2.1) days,(6.6±1.3) hours vs (12.3±2.0) hours, t=-18.605、-17.541、-15.113, all P<0.001]. There was no significant different in the operation time between study group and control group [(26.5±8.0) minutes vs (25.8±7.3) minutes, t=0.409, P=0.684]. The complication rate of the study group (2.5%) was significantly lower than that of the control group (2.5% vs 22.5%,χ^2=7.314, P=0.007). The immune inflammatory response indexes IgG、IgA、IgM、CPR、IL-6 on the 3rd day in the study group compared with the control group, were significantly improved (t=-3.526、-8.485、-5.262、13.091、20.155, all P<0.001). There was no recurrence in the both groups after one-year follow-up (χ2=0.513, P=0.474). Conclusion The laparoscopy surgery in the treatment of children with incarcerated indirect inguinal hernia is significant efficiency and it can reduce the short-term immune inflammatory response after surgery. However, in view of its prognosis, it is necessary to further increase the number of research cases for further study.

关 键 词：嵌顿性腹股沟斜疝 腹腔镜 免疫炎性反应 预后. 

分 类 号：R726.5[医药卫生—儿科]