斜疝患儿行腹腔镜下疝囊高位结扎术后的复发及危险因素分析

发布时间：2018-05-25 16:39

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:探讨与行腹腔镜下疝囊高位结扎术斜疝患儿术后复发的因素。方法:收集2013年1月—2016年1月期间行腹腔镜下疝囊高位结扎术的306斜疝患儿临床资料,对影响患儿术后复发的相关危险因素进行统计学分析。结果:306例患儿(401侧)中,13例复发,复发率为3.24%。单变量分析显示,斜疝患儿的年龄、内环口直径和结扎线的选择与腹腔镜下疝囊高位结扎术术后复发有关(χ~2=6.275、9.145、11.371,P=0.043、0.010、0.001);多变量Logistic回归分析显示,年龄与内环口直径较大以及用可吸收线结扎是腹腔镜下疝囊高位结扎术术后复发的独立危险因素(OR=3.466,95%CI=1.432~8.389;OR=1.988,95%CI=1.237~3.194;OR=1.089,95%CI=1.015~1.168,均P0.05)。结论:年龄与内环口直径较大以及可吸收线的使用是导致斜疝患儿行腹腔镜下疝囊高位结扎术术后复发的主要危险因素,对存在危险因素的患儿应考虑改良的腹腔镜手术方法、加强术后监护,并避免使用可吸收线,减少复发的发生。
[Abstract]:Objective: to investigate the factors of recurrent hernia after laparoscopic high ligation of hernia sac. Methods: the clinical data of 306 children with indirect hernia undergoing laparoscopic high ligation of hernia sac from January 2013 to January 2016 were collected and the risk factors affecting recurrence were analyzed statistically. Results the recurrence rate was 3.24% in 13 out of 306 cases (401 sides). Univariate analysis showed that the age, the diameter of the inner ring and the choice of ligation line were related to the recurrence of high ligation of hernia sac under laparoscope (蠂 ~ 2 / 2 6.275 / 9.145 / 11.371P 0.043 / 0.010 / 0.001), and multivariate Logistic regression analysis showed that there was no significant difference between the two groups. Age, diameter of inner ring and ligation with absorbable line were the independent risk factors of recurrence after laparoscopic high ligation of hernia sac. Conclusion: age, diameter of inner ring and the use of absorbable line are the main risk factors for recurrence of children with indirect hernia after laparoscopic high ligation of hernia sac. The modified laparoscopic operation method should be considered for children with high ligation of hernia sac under laparoscope. Strengthen postoperative monitoring and avoid the use of absorbable lines to reduce recurrence.
【作者单位】：江苏省无锡市儿童医院小儿外科;
【分类号】：R726.5

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