经脐单切口腹腔镜术与常规腹腔镜术在儿童腹股沟疝疝囊高位结扎术中的应用对比研究  

Comparative study on application of transumbilical single incision laparoscopic surgery and conventional laparoscopic surgery in high ligation of hernia sac for inguinal hernia in children

作　　者：瞿晶[1] 雷桂花[1] 吴小 秦连进[2] QU Jing;LEI Gui-hua;WU Xiao;QIN Lian-jin(Department of Pediatric Surgery,Lishui People′s Hospital,Lishui,Zhejiang 321300,China;不详)

机构地区：[1]丽水市人民医院小儿外科,浙江丽水321300 [2]湖州市第一人民医院小儿外科

出　　处：《中国妇幼保健》2024年第24期5009-5012,共4页Maternal and Child Health Care of China

基　　金：浙江省卫生健康科技计划(2020ZH009)。

摘　　要：目的探析儿童腹股沟疝采用常规与经脐单切口腹腔镜手术进行疝囊高位结扎的对比分析。方法纳入2022年5月—2023年5月丽水市人民医院收治的儿童腹股沟疝患儿98例,均采用腹腔镜手术治疗,其中常规组(三孔腹腔镜)52例、单切口组(经脐单切口腹腔镜)46例。观察两组手术效果和P物质(SP)、前列腺素E2(PGE2)、谷胱甘肽(GSH)及血管紧张素Ⅱ(Ang-Ⅱ)水平,观察术后并发症发生率及术后1年内腹股沟疝复发情况。结果单切口组下床活动时间(12.34±1.86)h明显早于常规组的(15.78±2.46)h,差异有统计学意义(P<0.05);术中失血量(8.03±2.04)ml明显少于常规组的(12.53±3.75)ml,差异有统计学意义(P<0.05);单切口组手术时间(21.03±4.18)min与常规组(19.52±3.87)比较,差异无统计学意义(P>0.05);术后单切口组Ang-Ⅱ水平(102.33±18.53)nmol/ml明显低于常规组的(112.27±23.84)nmol/ml,差异有统计学意义(P<0.05),GSH水平(5.82±0.48)nmol/ml明显高于常规组的(5.35±0.39)nmol/ml,差异有统计学意义(P<0.05);术后单切口组SP、PGE2水平(65.47±10.62)pg/ml、(18.47±4.52)ng/ml明显明显低于常规组的(71.65±11.47)pg/ml、(23.88±5.16)ng/ml,差异有统计学意义(P<0.05);单切口组并发症发生率(6.52%)明显低于常规组(21.15%),差异有统计学意义(P<0.05);单切口组与常规组1年内腹股沟疝复发率分别为8.70%、3.85%,差异无统计学意义(P>0.05)。结论儿童腹股沟疝采用经脐单切口腹腔镜手术进行疝囊高位结扎能减少术中失血量,缩短下床活动时间,减轻应激和疼痛因子水平,从而有助于降低手术并发症的发生风险。Objective To explore and analyze the comparative analysis of high ligation of hernia sac in children with inguinal hernia by conventional and transumbilical single incision laparoscopic surgery.Methods Totally 98 children with inguinal hernia in Lishui People′s Hospital were included from May 2022 to May 2023,and they were treated with laparoscopic surgery,including 52 cases in the conventional group(three-port laparoscopy)and 46 cases in the single incision group(transumbilical single incision laparoscopy).The surgical effect and levels of substance P(SP),prostaglandin E2(PGE2),glutathione(GSH)and angiotensinⅡ(Ang-Ⅱ)were observed in the two groups.The incidence of postoperative complications and recurrence of inguinal hernia within 1 year after surgery were observed.Results The ambulation time in the single incision group with(12.34±1.86)h was significantly earlier than(15.78±2.46)h in the conventional group(P<0.05),and the intraoperative blood loss with(8.03±2.04)ml was significantly less than(12.53±3.75)ml in the conventional group(P<0.05),but there was no significant difference in the surgical time between the single incision group and the conventional group[(21.03±4.18)min vs.(19.52±3.87)min](P>0.05).After surgery,the Ang-Ⅱlevel with(102.33±18.53)nmol/ml in the single incision group was significantly lower than(112.27±23.84)nmol/ml in the conventional group(P<0.05)while the GSH level with(5.82±0.48)nmol/ml was significantly higher compared with(5.35±0.39)nmol/ml in the conventional group(P<0.05).The levels of SP and PGE2 were(65.47±10.62)pg/ml and(18.47±4.52)ng/ml in the single incision group after surgery,which were significantly lower than(71.65±11.47)pg/ml and(23.88±5.16)ng/ml in the conventional group(P<0.05).The incidence of complications in the single incision group(6.52%)was significantly lower than that in the conventional group(21.15%)(P<0.05).The recurrence rates of inguinal hernia in the single incision group and the conventional group within 1 year were 8.70%and 3.85%respect

关 键 词：腹股沟疝 经脐单切口腹腔镜手术 两孔腹腔镜手术 疝囊高位结扎 儿童 

分 类 号：R726[医药卫生—儿科]