腹腔镜手术分类治疗儿童腹股沟斜疝  

Laparoscopic Individualized Surgery in Treatment of Pediatric Indirect Inguinal Hernia

作　　者：李杨[1] 王霞 尚培中[1] 张克勤 翟佳琪 张金江 LI Yang;WANG Xia;SHANG Pei-zhong;ZHANG Ke-qin;ZHAI Jia-qi;ZHANG Jin-jiang(Department of General Surgery,The 81 st Group Army Hospital of the PLA,Zhangjiakou,Hebei 075000,China;Outpatient Department,Huailai Shiji Hospital,Huailai,Hebei 075400,China;Department of Paediatrics,Maternal and Child Health Care Hospital of Zhangjiakou City,Zhangjiakou,Hebei 075000,China)

机构地区：[1]中国人民解放军陆军第八十一集团军医院普通外科,河北张家口075000 [2]怀来世济医院门诊部,河北怀来075400 [3]张家口市妇幼保健院小儿科,河北张家口075000

出　　处：《河北北方学院学报（自然科学版）》2022年第12期21-24,27,共5页Journal of Hebei North University:Natural Science Edition

基　　金：张家口市大健康和生物医疗专项重点研发计划项目(No.2121050D)。

摘　　要：目的探讨腹腔镜手术分类治疗儿童腹股沟斜疝的安全性及临床效果。方法选取135例腹股沟斜疝患儿分为腹腔镜组85例和开放组50例,对比分析2组患儿手术时间、出血量、术后24 h疼痛评分及侧隐性疝、术区肿胀、3年复发等8项临床指标。结果(1)腹腔镜组与开放组手术时间分别为(20.8±9.8)、(24.4±5.6)min,出血量分别为(2.9±1.5)、(6.2±2.2)mL,术后24 h疼痛评分分别为(1.5±0.4)、(3.7±0.5)分,住院时间分别为(3.0±1.1)、(4.5±1.3)d,组间比较差异有统计学意义(P<0.05);(2)腹腔镜组与开放组发现对侧隐性疝例数分别为10(11.8%)、0(0.0%)例,术区肿胀分别为1(1.2%)、6(12.0%)例,组间比较差异有统计学意义(P<0.05);3年复发分别为5(5.9%)、3(6.0%)例,2组中男性儿童3年均未发生缺血性睾丸炎或睾丸萎缩,组间差异无统计学意义(P>0.05)。结论根据儿童年龄及疝囊颈大小分别采取相应的腹腔镜手术方式,技术上安全、可行,术后复发率与开放手术相当。Objective To evaluate the safety and clinical efficacy of laparoscopic individualized surgery in the treatment of pediatric indirect inguinal hernia.Methods A total of 135 cases of pediatric indirect inguinal hernia were divided into laparoscopic group(n=85)and open group(n=50).Eight clinical indexes between the two groups were contrastively analyzed.Results(1)Four indexes of measurement data:the time of operation,intraoperative blood loss,pain score at 24 h after return to ward by numerical rating scale(NRS),and hospitalization time,were(20.8±9.8)min,(2.9±1.5)mL,(1.5±0.4)scores,(3.0±1.1)d in laparoscopic group and(24.4±5.6)min,(6.2±2.2)mL,(3.7±0.5)scores,(4.5±1.3)d in open group,respectively.The difference between the two groups were statistically significant(P<0.05).(2)Four indexes of enumeration data:contralateral occult hernia found at the time of operation,cases of swelling in surgical area were 10(11.8%),1(1.2%)in laparoscopic group and 0,6(12.0%)in open group,respectively.The difference between the two groups were statistically significant(P<0.05).3-year recurrence and 3-year ischemic orchitis or testicular atrophy were 5(5.9%),0 in laparoscopic group and 3(6.0%),0 in open group,respectively.There was no significant difference(P>0.05).Conclusion Laparoscopic individualized surgery according to age and hernia sac size in the treatment of pediatric indirect inguinal hernia is safe and feasible,with similar recurrence rates to the open surgery.

关 键 词：腹股沟斜疝 腹腔镜 疝囊高位结扎术 疝修补术 脐内侧襞瓣 

分 类 号：R656.21[医药卫生—外科学]