单孔腹腔镜联合ERAS策略在小儿腹股沟斜疝中的临床应用  

Clinical application of single-port laparoscopic surgery based on ERAS principle for children with indirect inguinal hernia

作　　者：段建平 朱林春 李志刚 龚忠星 叶会鹏 谢飞鸽 熊辉 张金花 邓先阳 邓胜华 Duan Jianping;Zhu Linchun;Li Zhigang;Gong Zhongxing;Ye Huipeng;Xie Feige;Xiong Hui;Zhang Jinghua;Deng Xianyang;Deng Shenghua(Department of General Surgery,NanXiong Peoples Hospital,Guangdong 512400,China;Department of Anesthesiology,NanXiong Peoples Hospital,Guangdong 512400,China)

机构地区：[1]南雄市人民医院普外科,广东南雄512400 [2]南雄市人民医院麻醉科,广东南雄512400

出　　处：《中华普外科手术学杂志（电子版）》2021年第5期578-580,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：广东省韶关市科学技术研究基金项目(Y20128)。

摘　　要：目的探讨单孔腹腔镜联合ERAS策略在小儿腹股沟斜疝临床应用的安全性和可行性。方法自2019年10月至2021年1月对100例小儿腹股沟斜疝手术患者,随机分为传统和ERAS两组。传统组采用常规氯氨酮全麻下行开放小儿疝囊高位结扎术;ERAS组采用气管插管全麻下行单孔腹腔镜小儿疝囊高位结扎术的腹腔镜手术。采用SPSS22.0软件进行统计学分析,围术期各项指标以(±s)表示,独立t检验;术后并发症采用χ^(2)检验,满意度调查采用秩和检验。P<0.05为差异有统计学意义。结果ERAS组手术出血量、手术时间和住院天数显著少于传统组(P<0.05);ERAS组术后疼痛率10.0%(5/50),显著少于传统组的62.0%(31/50);ERAS组术后出现恶心呕吐率20.0%(10/50),少于传统组的46.0%(23/50),两组差异均有统计学意义(P<0.05);ERAS组非常满意病例数为47例(94.0%),显著高于传统组的25例(50.0%),且ERAS组无不满意病例。结论在ERAS理念的指引下,利用单孔腹腔镜进行小儿疝囊高位结扎手术,具有创伤小,康复快,不仅达到了微创效果,又能提高病床使用率和周转率,缩短了住院时间,因此具有良好的临床应用前景。Objective To investigate the safety and feasibility of single-port laparoscopic surgery based on ERAS principle for children with indirect inguinal hernia.Methods From October 2019 to January 2021,100 children with indirect inguinal hernia received the surgery were randomly divided into the traditional group and the ERAS group.Patients in the traditional group received the open surgery of high ligation of the hernial sac under the general anesthesia with conventional ketamine;while patients in the ERAS group underwent single-port laparoscopic surgery of high ligation of the hernial sac under the general anesthesia with the trachea cannula.Statistical analysis were performed by using SPSS22.0 software.The perioperative indicators were expressed as,and were examined by using independent t test.Postoperative complications were analyzed by usingχ^(2) test.The satisfaction survey was analyzed by using the rank-sum test.A P value of<0.05 was considered as statistically significant difference.Results The intraoperative blood loss,time of surgery,and hospital stay in the ERAS group were significantly less than those in the traditional group respectively(P<0.05).The complaint of postoperative pain of 10.0%(5/50)in the ERAS group was significantly lower than 62.0%(31/50)in the traditional group(P<0.05).The incidence of nausea or vomiting of 20.0%in the ERAS group after surgery was much lower than 46.0%in the traditional group(P<0.05).The satisfaction of 94.0%(47/50)in the ERAS group was significantly more than 50.0%(25/50)in the traditional group,with no case of dissatisfaction in the ERAS group.Conclusion Based on ERAS principle,single-port laparoscopic surgery for children with indirect inguinal hernia is characterized as minimally-invasive and rapid recovery,furthermore with improved utilization of hospital resource.Therefore,it has a great clinical application prospect.

关 键 词：疝 腹股沟 腹腔镜 单孔目 加速康复外科 疝囊高位结扎手术 

分 类 号：R726.5[医药卫生—儿科]