单孔腹腔镜与腹股沟小切口治疗小儿鞘膜积液的临床效果比较  

Clinical effect comparison between single-port laparoscopy and small inguinal incision in the treatment of pediatric hydrocele

作　　者：陈锦荣 陈文有 王燕惠 叶风光 杨锋彬 简紫微 CHEN Jin-rong;CHEN Wen-you;WANG Yan-hui;YE Feng-guang;YANG Feng-bin;JIAN Zi-wei(Department of Pediatric Surgery,Zhangzhou Municipal Hospital of Fujian Province,Zhangzhou363000,China)

机构地区：[1]福建省漳州市医院小儿外科,福建漳州363000

出　　处：《中国当代医药》2020年第15期153-156,共4页China Modern Medicine

摘　　要：目的比较单孔腹腔镜与腹股沟小切口治疗小儿鞘膜积液的临床效果。方法回顾性分析2014年6月~2018年5月我院收治的633例鞘膜积液患儿的临床资料,根据纳入及排除标准,最终纳入546例,按照治疗方法的不同将其分为腹腔镜组(303例)及开放手术组(243例)。腹腔镜组患儿采用单孔腹腔镜单次双线鞘状突高位结扎术,开放手术组患儿采用腹股沟小切口手术。比较两组患儿的手术时间、住院时间、术中出血量、住院费用、术后并发症总发生率及复发率。结果腹腔镜组患儿的手术时间[单侧(17.9±2.5)min、双侧(27.7±2.6)min]分别短于开放手术组[(24.9±3.3)、(40.8±3.1)min],住院时间[(2.6±0.7)d]短于开放手术组[(3.9±1.6)d],术中出血量[(1.2±0.4)ml]少于开放手术组[(2.2±1.0)ml],住院费用[(6076.5±496.6)元]高于开放手术组[(3665.1±444.3)元],术后并发症总发生率(0.7%)低于开放手术组(11.9%),差异均有统计学意义(P<0.05)。术后随访1年,腹腔镜组患儿的复发率(0.7%)与开放手术组(2.1%)比较,差异无统计学意义(P>0.05)。结论单孔腹腔镜单次双线鞘状突高位结扎术治疗小儿鞘膜积液安全有效,较腹股沟小切口手术有明显优势,值得在临床上推广应用。Objective To compare the clinical effect between single-port laparoscopy and small inguinal incision in the treatment of pediatric hydrocele.Methods The clinical data of 633 children with hydrocele admitted to our hospital from June 2014 to May 2018 were retrospectively analyzed.According to the inclusion and exclusion criteria,546 children were finally included.They were divided into laparoscopic group(303 cases)and open operation group(243 cases)according to different treatment methods.The single-port laparoscopic high ligation of double-line sheath process was performed in the laparoscopic group,while the small inguinal incision was performed in the open operation group.The operation time,hospitalization time,intraoperative blood loss,hospitalization expense,total incidence rate of postoperative complications and recurrence rate of the two groups were compared.Results The operation time(unilateral[17.9±2.5]min,bilateral[27.7±2.6]min)of the laparoscopic group was shorter than that of the open operation group(unilateral[24.9±3.3]min,bilateral[40.8±3.1]min),the hospitalization time([2.6±0.7]d)was shorter than that of the open operation group([3.9±1.6]d),and the intraoperative blood loss([1.2±0.4]ml)was less than that of the open operation group([2.2±1.0]ml),the hospitalization expense([6076.5±496.6]yuan)was higher than that of the open operation group([3665.1±444.3]yuan),and the total incidence rate of postoperative complications(0.7%)was lower than that of the open operation group(11.9%),the differences were statistically significant(P<0.05).After 1 year of follow-up,the recurrence rate in the laparoscopic group(0.7%)was not significantly different from that in the open operation group(2.1%)(P>0.05).Conclusion The single-port laparoscopic high ligation of double-line sheath process has obvious advantages over small inguinal incision in terms of effect and safety for pediatric hydrocele,and it is worthy of clinical promotion.

关 键 词：小儿鞘膜积液 单孔腹腔镜手术 腹股沟小切口 鞘状突高位结扎术 

分 类 号：R765.4[医药卫生—耳鼻咽喉科]