经腹膜外腹腔镜治疗的腹股沟疝儿童预后的影响因素分析  

Analysis of factors affecting the prognosis of children with inguinal hernia treated by extraperitoneal laparosco⁃py

作　　者：瞿晶[1] 雷桂花[1] 吴小青[1] 叶蓓 QU Jing;LEI Guihua;WU Xiaoqing(Department of Pediatric Surgery,Lishui People's Hospital,Lishui 323000,China.)

机构地区：[1]丽水市人民医院小儿外科,浙江丽水323000

出　　处：《全科医学临床与教育》2024年第9期807-809,835,共4页Clinical Education of General Practice

摘　　要：目的 探究经腹膜外腹腔镜治疗的腹股沟疝儿童预后的影响因素。方法 选取接受经腹膜外腹腔镜疝气修补术治疗的腹股沟疝患儿120例。根据患儿术后1个月内预后情况分为预后不良组(n=28)和预后良好组(n=92)。比较两组患儿性别、年龄、腹股沟疝部位、疝囊长径、术中出血量、手术时间、住院时间、术前及术后疼痛程度、健康情况、炎症指标水平。通过多因素logistic回归分析患儿不良预后的危险因素。结果 单因素分析显示,预后不良组患儿手术时长、术后1个月视觉模拟评分法(VAS)评分、术后C反应蛋白(CRP)、白介素-6(IL-6)水平以及术后1个月儿童焦虑性情绪障碍筛查表(SCARED)评分均明显高于预后良好组,差异均有统计学意义(t分别=3.57、3.12、3.30、2.98、3.95,P均<0.05)。多因素logistic回归分析显示手术时间长、术后SCARED评分高、血清CRP、IL-6水平高均是患儿预后不良的危险因素(OR分别=1.18、1.33、1.45、2.12,P均<0.05)。结论 经腹膜外腹腔镜治疗的腹股沟疝患儿手术时间长、心理健康受损及炎症反应均可能增加患儿不良预后的发生率,有效的心理疏导及减轻炎症是改善经腹膜外腹腔镜治疗的腹股沟疝患儿预后的重要方法。Objective To explore the influencing factors of prognosis in children with inguinal hernia treated by extra⁃peritoneal laparoscopy Methods A total of 120 children with inguinal hernia who underwent extraperitoneal laparo⁃scopic hernia repair surgery were enrolled in this study.According to the recovery status within one month after sur⁃gery,the patients were divided into a poor prognosis group(n=28)and a good prognosis group(n=92).The general data,blood loss,operation time,the preoperative and postoperative pain levels,health status,and inflammatory indica⁃tors risk factors for poor prognosis through Spearman correlation analysis and multivariate logistic regression analysis.Results Univariate analysis showed that the operation time,visual analogue scale(VAS)score,C-reactive protein(CRP),interleukin-6(IL-6)levels,and SCARED score in the poor prognosis group were significantly higher than those in the good prognosis group,and the differences were statistically significant(t=3.57,3.12,3.30,2.98,3.95,P<0.05).Multivariate logistic regression analysis showed that prolonged surgery time,high SCARED score,and high se⁃rum CRP and IL-6 levels were risk factors for poor prognosis(OR=1.18,1.33,1.45,2.12,P<0.05).Conclusion The longer operation time,unhealthy psychology,and inflammatory response in children with inguinal hernia treated by extraperitoneal laparoscopy may increase the incidence of poor prognosis.Therefore,effective psychological counseling,and inflammation reduction are important methods to improve the prognosis of children with inguinal hernia treated by extraperitoneal laparoscopy.

关 键 词：儿童 腹股沟疝 腹腔镜治疗 炎症水平 预后 

分 类 号：R726.5[医药卫生—儿科]