悬吊免气腹腹腔镜手术治疗小儿腹股沟疝的疗效分析  

Analysis of the curative effect of suspended airless laparoscopic surgery on inguinal hernia in children

作　　者：吴耿刚 王理想 刘连弟 WU Genggang;WANG Lixiang;LIU Liandi(Department of Nail and Breast Surgery,The Fourth Affiliated Hospital of Guangzhou Medical University,Guangzhou 511300,China)

机构地区：[1]广州医科大学附属第四医院甲乳外科,511300

出　　处：《临床外科杂志》2024年第12期1293-1297,共5页Journal of Clinical Surgery

摘　　要：目的 分析悬吊免气腹腹腔镜手术治疗小儿腹股沟疝的疗效。方法 2020年6月~2023年2月收治的腹股沟疝患儿180例。采用随机数字表法分为两组,每组各90例。对照组采用腹腔镜疝囊高位结扎术,观察组采用悬吊免气腹腔镜手术,对比两组临床疗效和手术情况、术后疼痛情况和应激指标水平,以及对睾丸体积和生活质量、并发症和复发率的影响。结果 两组患儿临床疗效比较差异无统计学意义(P>0.05);观察组手术情况优于对照组(P<0.05),观察组和对照组术后12小时简版McGill疼痛问卷评分分别为(23.23±5.11)分和(25.51±5.21)分,术后1天分别为(20.02±4.55)分和(22.73±4.46)分,术后3天分别为(11.76±1.71)分和(12.63±1.82)分,两组比较差异有统计学意义(P<0.05);观察组和对照组术后2天白细胞介素(IL)-6、IL-10、皮质醇(Cor)、丙二醛(MDA)分别为[(29.03±4.21)ng/L和(30.86±4.15)ng/L、(30.12±4.23)ng/L和(32.02±4.41)ng/L、(47.11±6.63)mmol/L和(50.17±6.71)mmol/L、(24.31±5.18)μmol/L和(26.63±5.25)μmol/L],两组比较差异有统计学意义(P<0.05);两组睾丸体积比较无统计学意义(P>0.05),观察组生活质量评分低于对照组(P<0.05);观察组阴囊水肿、腹股沟疼痛并发症发生率及复发率与对照组比较,差异无统计学意义(P均>0.05),但观察组皮下气肿率低于对照组(P<0.05)。结论 悬吊免气腹腹腔镜手术和腹腔镜疝囊高位结扎术在治疗小儿腹股沟疝方面具有较好的疗效,而前者在减轻术后疼痛和应激反应方面更具有优势。Objective To analyze the curative effect of suspended airless laparoscopic surgery on inguinal hernia in children.Methods 180 children with inguinal hernia who received treatment at the Fourth Affiliated Hospital of Guangzhou Medical University from June 2020 to February 2023 were selected.Random number table method was used to divide the patients into two groups,90 cases in each group.The control group underwent laparoscopic high ligation of hernia sac,the observation group was treated with suspended airless laparoscopic surgery,and the clinical efficacy and surgical situation,postoperative pain and stress index levels,as well as the impact on testicular volume and quality of life,complications,and recurrence rate were compared between the two groups.Results There was no statistically significant difference in clinical efficacy between the two groups of children(P>0.05).The surgical performance of the observation group was better than that of the control group(P<0.05).The scores of the simplified McGill pain questionnaire were(23.23±5.11)points and(25.51±5.21)points in the observation group and control group 12 hours after surgery,and(20.02±4.55)points and(22.73±4.46)points on the first day after surgery,respectively.3 days after surgery,the scores were(11.76±1.71)points and(12.63±1.82)points,respectively,and the difference between the two groups was statistically significant(P<0.05).On the second day after surgery,the elevated levels of stress indicators such as interleukin-6(IL-6),interleukin-10(IL-10),cortisol(Cor),and malondialdehyde(MDA)in the observation group were lower than those in the control group[(29.03±4.21)ng/L vs(30.86±4.15)ng/L,(30.12±4.23)ng/L vs(32.02±4.41)ng/L,(47.11±6.63)mmol/L vs(50.17±6.71)mmol/L,(24.31±5.18)μmol/L vs(26.63±5.25)μmol/L](all P<0.05).There was no statistically significant difference in testicular volume between the two groups(P>0.05),while the quality of life score of the observation group was lower than that of the control group(P<0.05).The incidence and recu

关 键 词：悬吊免气腹腔镜手术 腹腔镜高位结扎术 小儿腹股沟疝气 疼痛 应激反应 

分 类 号：R65[医药卫生—外科学]