腹腔镜下硬膜外穿刺针及微型抓钳辅助治疗小儿鞘膜积液和斜疝临床分析  

Clinical experience of laparoscopic epidural puncture needle and micro clamp in the treatment of hydrocele and indirect hernia in children

作　　者：唐海洲[1] 何昌景 杨迪 李玉峰[1] 吕昌恒[1] TANG Haizhou;HE Changjing;YANG Di;LI Yufeng;LV Changheng(Department of Pediatric Surgery,Affiliated Hospital of Youjiang Medical University for Nationalities,Baise 533000,Guangxi,China)

机构地区：[1]右江民族医学院附属医院小儿外科,广西百色533000

出　　处：《右江医学》2020年第4期261-265,共5页Chinese Youjiang Medical Journal

基　　金：百色市科学研究与技术开发计划项目(百科计20170511)。

摘　　要：目的探讨硬膜外穿刺针及微型抓钳在单孔腹腔镜治疗小儿鞘膜积液及腹股沟斜疝中的临床应用价值,通过总结和分析术中及术后遇到的问题,提出预防和处理方法。方法回顾分析2016年2月至2019年2月收治的鞘膜积液和腹股沟斜疝患儿,其中腹腔镜手术215例(鞘膜积液114例,腹股沟斜疝101例)为研究组,传统开放手术167例(鞘膜积液89例,腹股沟斜疝78例)为对照组,比较两组患儿的手术时间、术中出血量、住院时间、术后术区血肿发生率、复发率。结果两组患儿均成功手术,研究组术中发现对侧隐匿性疝25例,对侧鞘状突未闭28例,均同时一并手术。与对照组比较,研究组患儿手术时间明显缩短[(20.12±4.75)min VS(31.37±4.51)min],术中出血量明显减少[(1.10±0.53)mL VS(3.97±1.57)mL],术后术区血肿发生率明显降低(0.47%VS 4.79%)。结论腹腔镜下硬膜外穿刺针及微型抓钳辅助治疗小儿鞘膜积液和腹股沟斜疝手术创伤小,术后恢复快,值得临床广泛推广,具有很高的实用性。Objective To explore the clinical application value of the epidural puncture needle and the micro-grasping forceps in the treatment of the effusion and the inguinal hernia in the children with single-hole laparoscopic operation,the prevention and treatment methods were put forward by the continuous summarization and analysis,and the problems encountered during and after the operation.Methods From February 2016 to February 2019,382 cases of hydrocele and indirect inguinal hernia were treated in our hospital,including 215 cases of laparoscopic surgery(including 114 cases of hydrocele and 101 cases of indirect inguinal hernia) and 167 cases of traditional open surgery(89 cases of hydrocele and 78 cases of indirect inguinal hernia) as the control group.The incidence and recurrence rate of hematomas in the operation area after operation.Results Both groups were operated successfully.In the study group,25 cases of occult hernia were found and 28 cases were found in the contralateral sheath process,both of which were operated at the same time.Compared with the control group,the operation time of the children in the study group was significantly shortened[(20.12±4.75)min VS(31.37±4.51)min],the amount of intraoperative bleeding was significantly reduced[(1.10±0.53) mL VS(3.97±1.57) mL],and the incidence of hematomas in the postoperative area was significantly decreased(0.47%VS 4.79%).Conclusion The operation has small trauma and quick recovery,which is worth popularizing widely and has high practicability.

关 键 词：腹腔镜 小儿鞘膜积液 腹股沟斜疝 儿童 

分 类 号：R697.23[医药卫生—泌尿科学] R656.21[医药卫生—外科学]