行子宫圆韧带剥离的腹腔镜疝囊高位结扎术患儿近期疗效观察  

SHORT-TERM EFFICACY OF LAPAROSCOPIC HIGH LIGATION OF THE HERNIA SAC IN CHILDREN UNDERGOING UTE-RINE ROUND LIGAMENT DISSECTION

作　　者：孙永杰[1,2] 邢茂青 SUN Yongjie;XING Maoqing(Department of Pediatric Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266003, China)

机构地区：[1]青岛大学附属医院儿外科,山东青岛266003 [2]威海市妇幼保健院儿外科

出　　处：《精准医学杂志》2020年第3期226-229,共4页Journal of Precision Medicine

基　　金：国家自然科学基金资助项目(81502361)。

摘　　要：目的通过对女性腹股沟斜疝患儿行腹腔镜疝囊高位结扎术时是否剥离子宫圆韧带手术近期治疗效果进行比较,进一步探究术中剥离子宫圆韧带的可行性及该操作对手术时间、术后并发症的影响。方法选取2018年1月1日—2019年1月1日我科确诊为腹股沟斜疝并确定行腹腔镜疝囊高位结扎术的62例女性患儿,依据术中是否行子宫圆韧带剥离分为对照组和观察组。对照组术中不分离子宫圆韧带,将其与疝囊一并结扎;观察组术中将子宫圆韧带自后腹膜剥离,仅将疝囊高位结扎。对比两组患儿的手术时间、术后并发症发生情况。结果所有患儿均顺利完成手术,无中转开腹。两组手术时间比较差异无显著统计学意义(P>0.05)。术后随访0.5~1.0年,对照组有6例出现并发症,观察组术后仅1例出现腹股沟切口处血性渗出,两组比较差异有统计学意义(χ^2=4.402,P<0.05)。结论女性腹股沟斜疝患儿行腹腔镜疝囊高位结扎术时,术中行子宫圆韧带剥离可减少副损伤,降低术后并发症,具有可行性,值得提倡。Objective To compare the short-term efficacy of laparoscopic high ligation of the hernia sac with or without intraoperative dissection of the uterine round ligament in female children with indirect inguinal hernia,and to further explore the feasibility of intraoperative dissection of the uterine round ligament and its effect on operation time and postoperative complications.MethodsA total of 62 female children who were diagnosed with indirect inguinal hernia from January 1,2018 to January 1,2019 in our department and confirmed to undergo laparoscopic high ligation of the hernia sac were divided into control group and observation group according to whether intraoperative uterine round ligament dissection was performed.In the control group,the round ligament of the uterus was not separated during the operation,and it was ligated together with the hernia sac;in the observation group,the round ligament of the uterus was stripped from the posterior peritoneum during the operation,and only the hernia sac was highly ligated.The two groups were compared in terms of operation time and postoperative complications.Results The operation was completed successfully in all children without conversion to laparotomy.There was no significant difference in operation time between the two groups(P>0.05).During the postoperative follow-up period of 0.5 to 1.0 years,there occurred 6 cases of complications in the control group and only 1 case of blood effusion at the inguinal incision in the observation group,with a significant difference between the two groups(χ^2=4.402,P<0.05).Conclusion When laparoscopic high ligation of the hernia sac is performed in female children with indirect inguinal hernia,intraoperative uterine round ligament dissection can reduce concomitant injury and postoperative complications,so it is feasible and worth advocating.

关 键 词：疝 腹股沟 结扎术 腹腔镜检查 子宫圆韧带 治疗结果 女性 儿童 

分 类 号：R726.562.1[医药卫生—儿科]