自制穿刺带线针辅助单孔腹腔镜疝囊高位结扎术治疗小儿腹股沟疝

发布时间：2018-05-05 22:00

本文选题：疝 + 腹股沟　；参考：《中国普通外科杂志》2017年10期

【摘要】：目的:探讨自制穿刺带线针辅助单孔腹腔镜下疝囊高位结扎术中治疗小儿腹股沟疝的可行性与疗效。方法:回顾性分析2012年1月—2014年11月期间收治的47例小儿腹股沟疝患者资料,其中23例行自制穿刺带线针辅助单孔腹腔镜下疝囊高位结扎术(腹腔镜组),采用全身麻醉;24例行传统开放性疝囊高位结扎术(开放组),采用连续硬膜外麻醉。比较两组患者的相关临床指标。结果:腹腔镜手术均获成功,无中转开腹。与开放组比较,腹腔镜组手术时间缩短(8.26 min vs.36.54 min),术中出血量降低(0.63 m L vs.4.15 m L)、术后住院时间减少(1.39 d vs.3.75 d),但住院费用增加(6 682.18元vs.4 385.93元),差异均有统计学意义(均P0.05);腹腔镜组无术后并发症,开放组术后发生并发症5例,其中阴囊血肿3例,皮下血肿2例,两组总并发症发生率差异有统计学意义(0 vs.20.8%,P0.05)。两组随访期间均无复发病例。结论:自制穿刺带线针辅助下单孔腹腔镜治疗小儿腹股沟疝安全有效、具有微创、无明显瘢痕、并发症少等优点。
[Abstract]:Objective: to investigate the feasibility and effect of self-made puncture with wire needle and single-hole laparoscopic high ligation of hernia sac in the treatment of inguinal hernia in children. Methods: the data of 47 children with inguinal hernia from January 2012 to November 2014 were retrospectively analyzed. 23 cases were treated with self-made puncture and wire needle assisted laparoscopic high ligation of hernia sac (laparoscopic group), 24 cases of traditional open hernia sac high ligation (open group, continuous epidural anesthesia). To compare the related clinical indexes between the two groups. Results: all the laparoscopic operations were successful, and there was no conversion to open operation. Compared with the open group, In the laparoscopic group, the operative time was shortened by 8.26 min vs.36.54, the blood loss decreased by 0.63 mL / mL, and the postoperative hospitalization time decreased by 1.39 days, but the hospitalization cost increased by 6 682.18 yuan vs.4 385.93 yuan, the difference was statistically significant (all P 0.05), there were no postoperative complications in the laparoscopy group. In the open group, there were 5 cases of postoperative complications, including 3 cases of scrotal hematoma and 2 cases of subcutaneous hematoma. There was a statistically significant difference in the incidence of total complications between the two groups (P 0.05). No recurrence occurred during follow-up in both groups. Conclusion: single hole laparoscopy with wire needle is safe and effective in the treatment of inguinal hernia in children. It has the advantages of minimally invasive, no obvious scar and less complications.
【作者单位】：包头医学院第一附属医院普外科一病区;内蒙古包头市疾病预防控制中心;
【基金】：内蒙古自治区科学技术厅科技计划资助项目(201502080)
【分类号】：R726.5

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