单孔腹腔镜下硬膜外穿刺针与开腹疝囊高位结扎术治疗小儿嵌顿性斜疝的效果  

Effect of Single Port Laparoscopic Epidural Puncture Needle and Open Abdomen High Ligation of Hernia Sac in the Treatment of Incarcerated Indirect Hernia in Children

作　　者：李茂 庞勇 LI Mao;PANG Yong(The People’s Hospital of Nanchuan in Chongqing,Chongqing 408400,China;不详)

机构地区：[1]重庆市南川区人民医院,重庆408400

出　　处：《中外医学研究》2022年第14期48-51,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：2020年度重庆市南川区第一批科技计划项目(编号Cx202005)。

摘　　要：目的:对比单孔腹腔镜下硬膜外穿刺针与开腹疝囊高位结扎术治疗小儿嵌顿性斜疝(incarcerated indirect inguinal hernia)的效果。方法:选取2020年4月-2021年4月重庆市南川区人民医院收治的30例嵌顿性斜疝患儿。根据电脑随机盲选法将其分为试验组和对照组,各15例。对照组实施开腹疝囊高位结扎术治疗,试验组实施单孔腹腔镜下硬膜外穿刺针疝囊高位结扎术。比较两组围手术期指标,术后即刻(T_(0))、术后2 h(T_(1))、术后6 h(T_(2))、术后24 h(T_(3))疼痛情况,术前、术后3 d炎症指标,并发症及复发率。结果:试验组手术时间、住院时间均短于对照组,术中出血量少于对照组,术后首次下床活动时间早于对照组(P<0.05)。T_(0)、T_(1)、T_(2)、T_(3)时,试验组视觉模拟评分法(VAS)评分均低于对照组,差异均有统计学意义(P<0.05)。术后3 d,试验组C反应蛋白(CRP)、降钙素原(PCT)水平、白细胞计数均低于对照组(P<0.05)。试验组并发症发生率低于对照组(P<0.05)。患者术后随访6个月,两组复发率比较差异无统计学意义(P>0.05)。结论:与开腹疝囊高位结扎术相比,单孔腹腔镜下硬膜外穿刺针疝囊高位结扎术治疗嵌顿性斜疝,具有出血量少、手术时间短、术后恢复快、疼痛程度轻等优势,且可减轻机体炎性反应,术后并发症发生率低,疾病不易复发。Objective:To compare the effect of single port laparoscopic epidural puncture needle and open abdomen high ligation of hernia sac in the treatment of incarcerated indirect inguinal hernia in children.Method:A total of 30 children with incarcerated indirect hernia admitted to the People’s Hospital of Nanchuan in Chongqing from April 2020 to April 2021 were selected.According to the computer random blind selection method,they were divided into experimental group and control group,with 15 cases in each group.The control group was treated with open abdomen high ligation of hernia sac,and the experimental group was treated with high ligation of hernia sac with single port laparoscopic epidural puncture needle.The perioperative indexes,pain condition immediately after surgery(T_(0)),2 h after surgery(T_(1)),6 h after surgery(T_(2))and 24 h after surgery(T_(3)),inflammatory indexes before and 3 d after surgery,complications and recurrence rate were compared between the two groups.Result:The surgery time and hospital stay in the experimental group were shorter than those in the control group,the amount of intraoperative bleeding was less than that in the control group,and the first time out of bed activity time after surgery was earlier than that in the control group(P<0.05).At T_(0),T_(1),T_(2) and T_(3),the scores of visual analogue scale(VAS)in the experimental group were lower than those in the control group,and the differences were statistically significant(P<0.05).3 d after surgery,the levels of C-reactive protein(CRP),procalcitonin(PCT)and the white blood cell count in the experimental group were lower than those in the control group(P<0.05).The incidence of complications in the experimental group was lower than that in the control group(P<0.05).The patients were followed up for 6 months,there was no significant difference in the recurrence rate between the two groups(P>0.05).Conclusion:Compared with open abdomen high ligation of hernia sac,high ligation of hernia sac with single port laparoscopic epidural punct

关 键 词：斜疝 嵌顿性 小儿 疝囊高位结扎术 单孔腹腔镜 硬膜外穿刺针 传统开腹手术 

分 类 号：R726.5[医药卫生—儿科]