腹腔镜双线与单线疝囊结扎术治疗儿童巨大疝的效果评价  

Effectiveness evaluation of laparoscopic double-and single line hernia sac ligation for the treatment of massive hernia in children

作　　者：黎丽明 李云全 LI Liming;LI Yunquan(Department of Pediatric Surgery,Guiping People's Hospital,Guigang 537200,China)

机构地区：[1]桂平市人民医院小儿外科,广西贵港537200

出　　处：《腹腔镜外科杂志》2023年第10期763-767,共5页Journal of Laparoscopic Surgery

基　　金：贵港市科学研究与技术开发计划(贵科转1803015)。

摘　　要：目的:探讨腹腔镜下双线不同部位与单线疝囊高位结扎术治疗儿童巨大疝的临床效果及对血清金属蛋白酶组织抑制因子2、C反应蛋白的影响。方法:选取99例男性巨大腹股沟斜疝患儿,随机分为对照组(n=49,行腹腔镜单线疝囊高位结扎术)与研究组(n=50,行腹腔镜双线不同部位疝囊高位结扎术)。观察两组手术及术后康复情况、临床疗效、手术前后疼痛程度、血清金属蛋白酶组织抑制因子2、C反应蛋白水平、并发症发生率,术后随访1年,统计两组复发情况。结果:研究组手术时间长于对照组(P<0.05);两组术中出血量、术后首次肛门排气时间、下床活动时间、住院时间、并发症发生率及术后6 h、12 h、24 h、48 h疼痛评分差异无统计学意义(P>0.05);术后第1天、第3天、第7天两组血清金属蛋白酶组织抑制因子2、C反应蛋白水平差异无统计学意义(P>0.05)。术后随访1年,研究组复发率低于对照组(P<0.05)。结论:腹腔镜下双线不同部位结扎腹股沟内环口是治疗儿童巨大疝安全、可靠的术式,可提高临床疗效,降低术后复发风险,值得推广应用。Objective:To explore the clinical effect of laparoscopic high ligation of hernia sac with double-line and single line in the treatment of giant hernia in children and the influence on serum tissue inhibitor of metalloproteinase-2(TIMP-2)and C-reactive protein(CRP).Methods:Ninety-nine male children with giant inguinal hernia were selected and randomly divided into control group(49 cases)and study group(50 cases).The control group underwent laparoscopic high ligation of hernia sac with single line,and the study group underwent laparoscopic high ligation of hernia sac with double-line at different locations.The operative conditions,postopera-tive recovery,clinical efficacy,pain degree before and after operation,serum TIMP-2,CRP levels,and complication rate of the two groups were observed.The recurrence of the two groups was statistically compared after 1 year of postoperative follow-up.Results:The operation time of the study group was longer than that of the control group(P<0.05).There was no statistically significant difference between the two groups in the blood loss during operation,the time of first postoperative anal exhaust,the time of ambulation,the hospital stay,the incidence of complications,pain degree at 6 h,12 h,24 h and 48 h after surgery(P>0.05).There was no statistically significant difference in serum TIMP-2 and CRP levels between the two groups on day 1,day 3 and day 7 after surgery(P>0.05).The r ecurrence rate of the study group was lower than that of the control group after 1 year of postoperative follow-up(P<0.05).Conclusions:Laparoscopic ligation of the inguinal inner ring with double-line at different locations is a safe and reliable surgical method for g iant hernia in children,which can improve clinical efficacy and reduce the risk of postoperative recurrence.It is worth promoting and applying in clinical practice.

关 键 词：疝 腹股沟 腹腔镜检查 疝囊高位结扎术 双线 单线 儿童 

分 类 号：R656.2[医药卫生—外科学]