腹腔镜下鞘状突高位结扎术对小儿鞘膜积液治疗的效果及并发症研究  

Study on the efficacy and complications of laparoscopic high ligation of the sheath process in the treatment of hydrocele in children

作　　者：朱斌 吴其肯 胡昊勰 刘玉君 ZHU Bin;WU Qiken;HU Haoxie;LIU Yujun(Zhoushan Women's and Children's Hospital,Zhejiang 316000,China)

机构地区：[1]浙江省舟山市妇女儿童医院,舟山316000

出　　处：《浙江创伤外科》2023年第8期1421-1423,共3页Zhejiang Journal of Traumatic Surgery

摘　　要：目的探讨腹腔镜下鞘状突高位结扎术在小儿鞘膜积液治疗中的临床效果。方法回顾性收集2019年8月至2022年8月期间本院收治的112例鞘膜积液患儿,根据术中采用的手术方式划分为观察组(腹腔镜下鞘状突高位结扎术)56例和对照组(小切口高位结扎术)56例,比较分析两组数据指标。结果观察组患儿手术时间(21.54±1.88)min、住院时间(2.24±0.11)d及术中切口长度(6.11±0.24)mm均较对照组短[(27.41±2.65)min、(2.85±0.12)d和(28.65±3.12)mm],差异显著(P<0.05);观察组术中出血量(1.87±0.15)mL较对照组(3.24±0.22)mL少,差异显著(P<0.05);观察组患儿术后无痛32例,轻微不适17例,中度疼痛7例,对照组患儿无痛18例,轻微不适28例,中度疼痛8例,严重疼痛2例,秩和检验结果显示观察组疼痛评分表现优于对照组,差异显著(P<0.05);观察组术后发生阴囊血肿1例,对照组术后发生阴囊血肿5例、切口感染3例及肠粘连2例,观察组术后并发症发生率(1.79%)远低于对照组(17.86%),差异有统计学意义(P<0.05)。结论腹腔镜下鞘状突高位结扎术在小儿鞘膜积液治疗中的临床效果优异,可以降低患儿术后疼痛的同时减少并发症的发生,值得临床借鉴推广。Objective to investigate the clinical effect of high ligation of sphingoid process under laparoscope in the treatment of pediatric hydrocele.Methods a total of 112 children with hydrocele treated in our department from August 2019 to August 2022 were retrospectively enrolled and divided into an observation group(high ligation of sphingoid process under laparoscopic)of 56 cases and a control group(high ligation of small incision)of 56 cases according to the intraoperative procedure adopted,and the data indicators of the two groups were compared and analyzed.Results Patients in the observation group had shorter operative time(21.54±1.88)min,hospital stay(2.24±0.11)d and intraoperative incision length(6.11±0.24)mm than those in the control group[(27.41±2.65)min,(2.85±0.12)d and(28.65±3.12)mm](P<0.05).The amount of intraoperative blood loss in the observation group(1.87±0.15)mL was less than that in the control group(3.24±0.22)mL,and the difference was significant(P<0.05).Patients in the observation group reported no pain after surgery(n=32),slight discomfort(n=17),moderate pain(n=7),and in the control group reported no pain(n=18),slight discomfort(n=28),moderate pain(n=8),and severe pain(n=2).The results of the rank sum test showed that the pain scores of the observation group performed better than those of the control group with significant differences(P<0.05).1 patient in the observation group developed postoperative scrotal hematoma,5 patients in the control group developed postoperative scrotal hematoma,3 patients with incision infection and 2 patients with intestinal adhesions,and the incidence of postoperative complications in the observation group(1.79%)was much lower than that in the control group(17.86%),with significant differences(P<0.05).Conclusion The excellent clinical results of laparoscopic high ligation of the sphingoid process in the treatment of pediatric hydrocele,which can reduce postoperative pain in children while reducing the occurrence of complications,deserve to be promoted by clini

关 键 词：鞘膜积液 腹腔镜 腹股沟小切口 高位结扎术 

分 类 号：R725.4[医药卫生—儿科]