钳式针一步法在小儿腹腔镜疝囊高位结扎术中的应用效果  

Application effect of one-step forceps needle method in laparoscopic high ligation of hernia sac in children

作　　者：杨小栎 李万富[1] 马柱[1] 马兰[1] 郑义 付晓丽[1] 王晶[1] Yang Xiaoli;Li Wanfu;Ma Zhu;Ma Lan;Zheng Yi;Fu Xiaoli;Wang Jing(The First Affiliated Hospital of Xinjiang Medical University,Pediatric General Surgery/Pediatric Urology,Urumqi Xinjiang 830054,China)

机构地区：[1]新疆医科大学第一附属医院小儿普外科/小儿泌尿外科,乌鲁木齐830054

出　　处：《中华普外科手术学杂志（电子版）》2024年第5期535-538,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：自治区科技支疆项日(2020E0267)。

摘　　要：目的:探讨钳式针一步法在小儿腹股沟斜疝行腹腔镜疝囊高位结扎术中的应用效果。方法:回顾性分析2019年10月至2022年10月900例接受腹腔镜疝囊高位结扎术治疗的小儿腹股沟斜疝患儿临床资料,根据腹壁穿刺方式不同将其分为两组:一步法组予以钳式针一步法腹壁穿刺(n=470例),二步法组予以硬膜外穿刺针二步法腹壁穿刺(n=430例)。以SPSS25.0软件进行统计学分析,并发症、疼痛程度和复发等计数资料以[例(%)]描述,采用χ^(2)检验;围手术期各项指标等计量资料以(x±s)描述,组间对比行独立样本t检验。P<0.05为差异有统计学意义。结果:两组患者手术时间、术中出血量、切口长度、住院时间及并发症发生率比较差异无统计学意义(P>0.05);一步法组患者术后24h疼痛程度轻于二步法组,且术后1年复发率低于二步法组(P<0.05)。结论:钳式针一步法腹壁穿刺以及硬膜外穿刺针二步法腹壁穿刺均为小儿腹股沟斜疝实施腹腔镜疝囊高位结扎术治疗的有效穿刺手段,手术安全性相当,但一步法更有助于缓解患者术后疼痛,同时能够减少患者术后病情复发。Objective:To investigate the effect of one-step forceps needle method in laparoscopic high ligation of hernia sac in children with oblique inguinal hernia.Methods:The clinical data of 900 children with oblique inguinal hernia who received laparoscopic high ligation of hernia capsule from October 2019 to October 2022 were retrospectively analyzed,and they were divided into two groups according to different abdominal wall puncture methods:In the one-step group,forceps needle one-step abdominal wall puncture(470 cases),and in the two-step group,epidural puncture needle two-step abdominal wall puncture(430 cases).SPSS25.0 software was used for statistical analysis.The statistical data of complications,pain degree and recurrence were described by[cases(%)]andχ^(2) test was used.Perioperative indicators and other measurement data were described as(x±s),and independent sample t test was performed for comparison between groups.P<0.05 was considered statistically significant.Results:There was no significant difference in operation time,intraoperative blood loss,incision length,hospital stay and complication rate between the two groups(P>0.05).The severity of pain in the one-step group was less than that in the two-step group 24 hours after surgery,and the recurrence rate at 1 year after surgery was lower than that in the two-step group(P<0.05).Conclusion:One-step abdominal wall puncture with forceps needle and two-step abdominal wall puncture with epidural puncture needle are both effective puncture methods for laparoscopic high ligation of hernia sac in children with oblique inguinal hernia,with similar surgical safety.However,one-step puncture is more helpful to relieve postoperative pain and reduce postoperative recurrence of patients.

关 键 词：小儿腹股沟斜疝 疝囊高位结扎术 腹壁穿刺 腹腔镜 

分 类 号：R726.5[医药卫生—儿科]