精索静脉直径对小儿隐匿性腹股沟斜疝诊断的预测价值研究  

Prediction value of spermatic vein diameter in diagnosis of occult oblique inguinal hernia in children

作　　者：吴红军 高峰 朱赢 陈伟强 王佳伟 汪芬华 WU Hongjun;GAO Feng;ZHU Ying;CHEN Weiqiang;WANG Jiawei;WANG Fenhua(Department of Pediatric Surgery,Hangzhou Linping District Maternal&Child Health Care Hospital,Hangzhou 311100,Zhejiang,China;Department of Ultrasound,Hangzhou Linping District Maternal&Child Health Care Hospital,Hangzhou 311100,Zhejiang,China;Department of Surgical,Hangzhou Linping District Maternal&Child Health Care Hospital,Hangzhou 311100,Zhejiang,China)

机构地区：[1]杭州市临平区妇幼保健院小儿外科,浙江杭州311100 [2]杭州市临平区妇幼保健院超声科,浙江杭州311100 [3]杭州市临平区妇幼保健院外科,浙江杭州311100

出　　处：《中国现代医生》2025年第5期32-34,共3页China Modern Doctor

基　　金：浙江省杭州市科技计划引导项目(20201231Y135)。

摘　　要：目的分析精索静脉直径对小儿隐匿性腹股沟斜疝诊断的预测价值。方法选取2021年8月至2023年8月杭州市临平区妇幼保健院收治的93例腹股沟斜疝患儿作为研究对象。双侧显性疝患儿15例30侧,单侧显性疝患儿78例78侧,其中单侧显性疝中经腹腔镜探查发现的对侧隐性疝为21例21侧。显性疝108侧作为显性疝组,隐性疝21侧作为隐性疝组。按照不同年龄分为1~3岁组60例,4~6岁组33例;腹股沟斜疝患儿按照不同病程分为<2年组68例,≥2年组25例。彩色超声诊断仪利用7.5MHz线性换能器,血流成像显示2mm/s后的信号测量患儿腹股沟区精索静脉直径。采用受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)分析精索静脉直径对小儿隐匿性腹股沟斜疝诊断的预测价值。结果与隐性疝组比较,显性疝组患儿精索静脉直径升高。与显性疝组比较,隐性疝组患儿精索静脉直径较小,差异有统计学意义(P<0.05)。不同年龄、不同病程下精索静脉直径对疾病诊断的预测,1~3岁年龄组患儿的敏感度低于4~6岁组,特异性较高;底程≥2年组患儿的敏感度低于<2年组,特异性较高,差异有统计学意义(P<0.05)。结论精索静脉直径可用于预测小儿隐匿性腹股沟斜疝诊断,且有较高的敏感度及特异性。Objective To analyze the predictive value of spermatic vein diameter in diagnosing occult oblique inguinal hernia in children.Methods A total of 93 children of oblique inguinal hernia were admitted to Hangzhou Linping District Maternal&Child Health Care Hospital from August 2021 to August 2023 as research objects,including 15 with 30 sides of bilateral dominant hernia and 78 with 78 sides of unilateral dominant hernia.Among them,21 with 21 sides of contralateral recessive hernia were found by laparoscopic exploration in unilateral dominant hernia.The 108 sides of dominant hernia were used as dominant hernia group and 21 sides of occult hernia group as recessive hernia group.According to different ages,the patients were divided into 1 to 3 years old group 60 cases,4 to 6 years old group 33 cases;Children with oblique inguinal hernia were divided into<2 years group(68 cases)and≥2 years group(25 cases).The color ultrasound diagnostic instrument uses a 7.5MHz linear transducer to measure the diameter of the spermatic vein in the inguinal region of the child using blood flow imaging with a signal displayed at 2mm/s.Receiver operating characteristic(ROC)curve analysis of the predictive value of spermatic vein diameter for the diagnosis of occult inguinal hernia in children.Results Compared with occult hernia group,diameter of spermatic cord was increased in dominant hernia group(P<0.05).Compared with overt hernia group,diameter of spermatic cord in<2 year group and≥2 year group was smaller,and difference was statistically significant(P<0.05).In prediction of disease diagnosis with different age and course of disease,sensitivity of 1 to 3 years old was lower than that of 4 to 6 years old,and specificity was higher.The sensitivity of≥2 years group was lower than that of<2 years group.The specificity was higher and difference was statistically significant(P<0.05).Conclusion diameter of spermatic vein can be used to predict the diagnosis of occult oblique inguinal hernia in children with high sensitivity and specific

关 键 词：精索静脉直径 小儿隐匿性腹股沟斜疝 预测价值 腹腔镜 

分 类 号：R726.1[医药卫生—儿科]