气腹针配合半硬性活检钳在腹腔镜小儿腹股沟斜疝手术中的应用  

Application of veress needle combined with semi-rigid biopsy forceps in laparoscopic surgery of indirect inguinal hernia in children

作　　者：吴鹏飞[1] 周细华 Wu Pengfei;Zhou Xihua(Department of General Surgery,Rugao People's Hospital,Rugao 226500,China)

机构地区：[1]江苏省如皋市人民医院普外科,226500

出　　处：《中国医师杂志》2021年第3期398-401,共4页Journal of Chinese Physician

基　　金：2020年度南通市卫生健康委员会青年课题(QB2020017)。

摘　　要：目的探讨使用气腹针配合半硬性活检钳行腹腔镜下小儿腹股沟斜疝疝囊高位结扎术的临床疗效.方法回顾性分析2018年6月至2019年11月如皋市人民医院收治的小儿腹股沟斜疝病例121例,根据手术方式分为腹腔镜组(n=76,运用气腹针配合半硬性活检钳行腹腔镜下疝旗高位结扎术)和传统手术组(n=45,行传统腹股沟区切口疝囊高位结扎),对比两组手术时间、术中出血量、手术切口长度、术后恢复自主活动时间、术后住院时间;术后随访3~21个月,比较两组发生术后并发症及复发病例的比例=结果两组手术时间比较差异无统计学意义(P=0.335),而腹腔镜组术中出血量[(3.8±0.7)ml vs(7.3±1.7)ml,t=6.277,P<0.05]、手术切口长度[(0.6±0.1)cm vs(1.8±1.2)cm,t=12.374,P<0.05]、术后恢复自主活动时间[(9.2±2.6)h vs(16.2±4.2)h,t=18.254,P<0.05]、术后住院时间[(1.3±0.6)d vs(3.4±1.3)d,t=5.003,p<0.05]均优于传统手术组;腹腔镜组术后随访期间出现并发症和复发的比例小于传统手术组(χ^(2)=5.243,P=0.022)。结论气腹针配合半硬性活检钳行腹腔镜小儿斜疝疝旗高位结扎术具有创伤小、恢复快、术后并发症少等优势,且器械易于获得,方便在基层医院开展、推广。Objective To explore the clinical effect of laparoscopic high ligation of inguinal hernia sac in children with veress needle and semi-rigid biopsy forceps.Methods 121 cases of indirect hernia of groin admitted in Rugao Peoples Hospital from June 2018 to November 2019 were analyzed retrospectively.According to the operation methods,121 cases were divided into laparoscopic group(n=76,laparoscopic high ligation of hernia sac with pneumoperitoneum needle and semi rigid biopsy forceps)and traditional operation gjoup(n=45,high ligation of traditional inguinal incision hernia sac).The operation time,intraoperative blood loss,incision length,postoperative self activity time and postoperative hospital stay were compared between the two groups;the patients were followed up for 3-21 months,and the proportion of postoperative complications and recurrence cases were compared between the two groups.Results There was no significant difference in operative time between the two groups(P=0.335),but the amount of bleeding[(3.8±0.7)ml vs(7.3±1.7)ml,P<0.05],the length of incision[(0.6±0.1)cm vs(1.8±1.2)cm,P<0.05],the time of recovery of self activity[(9.2±2.6)h vs(16.2±4.2)h,P<0.05]and the time of hospitalization[(1.3±0.6)d vs(3.4±1.3)d,P<0.05]in the laparoscopic group were all better than those in the traditional operation group;the proportion of complications and recurrence in the laparoscopic group during the follow-up pericxi was less than that in the traditional operation group(χ^(2)=5.243,P=0.022).Conclusions Ixiparoscopic high ligation of indirect hernia sac in children with veress needle and semi-rigid biopsy forceps has the advantages of small trauma,fast recovery and less postoperative complications,and the equipment is easy to obtain,whith is convenienl to carry out anti promote in basic hospitals.

关 键 词：腹腔镜检查 疝 腹股沟 儿童 

分 类 号：R726.5[医药卫生—儿科]