摘要
目的通过与传统切开疝修补术比较,评价自制导线针在小儿腹股沟斜疝腹腔镜治疗中的疗效及并发症。方法 260例腹股沟斜疝的儿童(嵌顿疝并行急诊传统手术者除外),据随机数字表将患者分为:对照组(120例)行传统切开疝修补术,腹腔镜组(140例)应用自制导线针行腹腔镜下疝囊高位结扎术,比较手术时间、术后伤口疼痛持续时间、术后并发症发生率(伤口出血、感染,尿潴留,血管、输精管及神经损伤,阴囊明显水肿、阴囊血肿,皮下血肿等),出院后随访复发率(30个月)。结果应用自制导线针为140例患儿行微型腹腔镜小儿腹股沟斜疝疝囊高位结扎术,手术过程顺利,与传统手术相比,手术时间、住院时间、切口疼痛持续时间明显更短(P<0.01)、并发症发生率更低(P<0.05)、复发率和住院费用则差异无统计学意义(P>0.05)。结论应用自制导线针行腹腔镜小儿腹股沟斜疝疝囊高位结扎术,切口小,损伤轻,疼痛轻,恢复快,手术时间及住院时间短,操作简单,安全,疗效可靠,可同时发现及处理对侧隐性内环口未闭,复发率低,并发症少,值得临床推广应用。
Objective To evaluate the effect and complications of self-made needle for Oblique inguinal hernia under laparoscopic treatment in children compared with traditional herniorrhaphy by cutting-off abdominal wall.Methods 260 children who have Oblique inguinal hernia（except for children who have incarceration and treated with emergent traditional herniorrhaphy） were divided into two groups on the basis of random numeration table： Control group（120 children）were treated with traditional herniorrhaphy and abdominoscope group（140 children） were treated by high ligation of the hernial sac around the inner ring under laparoscope.Both of them were contrasted with time of operation,time of pain postoperation,the rate of complication（hemorrhage,infection,urine retention,injury to blood vessels,deferent ducts and nerves,hematoma of scrotum,ecchymoma and so on）.Doing follow-up visit of recidivation（30 months）.Results 140 children were treated with self-made needle by laparoscopic surgery for Oblique inguinal hernia.The operative procedure,was uneventful.Compared with the operation opened abdominal cavity,the process of operation,the length of stay and the time of pain in incisal opening are shorter obviously（P0.01）.The rate of complication is lower（P0.05）.The relapse rate and the fee haven＇t obvious difference（P0.05）.Conclusion High ligation of the hernial sac with self-made needle under laparoscope for the treatment of Oblique inguinal hernia in children has the advantages of small incision,mininlal injury,rapid recovery and short operation time.Hidden patent internal rings can be found and treated.Therefore,it can be used widely.
出处
《四川医学》
CAS
2010年第6期773-775,共3页
Sichuan Medical Journal
关键词
微型腹腔镜
疝
腹股沟
儿童
自制导线针
micro-laparoscopy
hernia
inguinal
child
self-made needle
