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微型腹腔镜小儿腹股沟疝高位结扎术的临床应用研究

作者:常 斌

所属单位:河南省焦作市妇幼保健院外科 (河南 焦作 454000)

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摘要

目的 探究微型腹腔镜小儿腹股沟疝高位结扎术的临床应用价值。方法 将2016年9月-2017年10月入院的70例小儿腹 股沟疝患儿采用随机数表法分为研究组和对照组,每组35例。对照组采用传统术式,研究组采用微型腹腔镜下疝囊 高位结扎术。观察2组术中、术后一般情况,评估患儿疼痛状况(疼痛时间、术后6h疼痛强度[东大略儿童医院疼痛 评分(CHEOPS)]),记录患儿并发症发生率及6个月复发率。结果 ①研究组手术时间、切口长度、出血量、住院 时间、术后卧床时间均小于对照组(P<0.05);②研究组疼痛时间、术后6hCHEOPS评分均小于对照组(P<0.05); ③研究组术后发热率、6个月复发率均低于对照组(P<0.05),两组鞘膜积液、阴囊/大阴唇肿胀发生率对比差异无 统计学意义(P>0.05)。结论 微型腹腔镜小儿腹股沟疝高位结扎术能显著改善患儿术中、术后一般情况及疼痛状 况,在提供患儿治疗体验的同时降低术后发热率及复发率,临床应用价值可观。

Objective To explore the clinical value of mini-laparoscopic high ligation on inguinal hernia in children. Methods 70 children with inguinal hernia treated in hospital from Sep. 2016 to Oct. 2017 were randomly divided into study group (35 cases) and control group (35 cases). The control group was treated with conventional operation, while the study group was treated with mini-laparoscopic high ligation of hernial sac. The intraoperative and postoperative general situations in the two groups were observed, the pain conditions in the two groups were evaluated (pain time, pain intensity 6h after operation [Children’s Hospital EasternOntario Pain Scale,(CHEOPS)]), and the incidence rates of complications and recurrence rates 6 months after operation in the two groups were recorded. Results The operation time, incision length, blood loss, hospitalization time and postoperative bed time in the study group were all less than those in the control group (P<0.05), the pain time and CHEOPS score 6h after operation in the study group were all less than those in the control group (P<0.05), the postoperative fever rate and recurrence rate 6 months after operation in the study group were all lower than those in the control group (P<0.05), there was no significant difference in hydrocele and incidence of scrotum / labium majus swelling between the two groups (P>0.05). Conclusion Minilaparoscopic high ligation which has considerable value, can not only significantly improve the intraoperative and postoperative general situation and pain condition of children with inguinal hernia, but also reduce the postoperative fever and recurrence rates while providing treatment experience for children.

【关键词】微型腹腔镜;高位结扎术;小儿;腹股沟疝

【中图分类号】R726;R656.2

【文献标识码】A

【DOI】10.3969/j.issn.1009-3257.2018.03.020

前言

腹股沟疝是一种小儿常见疾病,由于我国计生政 策的改变,新生儿不断增多使近年来发病率相对升 高。手术是最有效的治疗手段,但临床观察发现,传 统开放手术手术创伤较大,不仅不利于患儿恢复,而 且术后并发症发生风险也较高[1]。随着微创技术的不 断进步,运用腹腔镜疝囊高位结扎术治疗小儿腹股沟 疝的优势逐渐得到医疗工作者的认可。基于此,本研 究选取我院收治的腹股沟疝患儿70例进行研究,以探讨微型腹腔镜小儿腹股沟疝高位结扎术的临床应用价 值,现报告如下。