摘要
目的比较腹腔镜与开放手术治疗小儿嵌顿疝的临床疗效,以减轻患儿病痛,提高患儿生活质量。方法选择100例单侧嵌顿疝患儿的临床资料,按手术方式不同分为腹腔镜组和开放组,各50例,比较两组术中出血量、手术时间、住院时间、术后并发症、排气时间及术后不同时间段的疼痛评分等指标;随访患儿术后并发症及复发发生情况。结果两组手术均顺利完成,两组术后复发率均为0。腹腔镜组中,10例术中发现双侧内环口未闭;开放组50例中,3例第一次手术后出现对侧腹股沟斜疝,需再次行手术治疗。与开放组相比,腹腔镜组手术时间明显缩短、出血量明显减少、术后住院时间明显缩短、术后疼痛均减轻(P<0.05)。结论腹腔镜手术治疗儿童嵌顿疝是安全有效的,具有手术时间短、创伤小、恢复快、痛苦小等优点,且可同时探查双侧内环口的闭合情况,如发现双侧内环口未闭合,可同时行双侧内环口高位结扎术,减少患儿二次手术及麻醉的风险,值得临床推广。
Objective To compare the clinical efficacy of laparoscopic surgery and open surgery in treatment of incarcerated inguinal hernia in children,so as to alleviate the pain and improve the quality of life for children.Methods A total of 100 children with unilateral incarcerated inguinal hernia were selected and divided into laparoscopic group(n=50)and open group(n=50)according to the surgery option.The blood loss,time of operation,length of stay,postoperative complications,exhaust time,pain score at different time points after the operation and other indexes were compared between the two groups.Follow-up was conducted for the children in terms of postoperative complications and recurrence.Results All operations were completed successfully in both groups,with recurrence rate of 0 after the operation.In the laparoscopic group,bilateral patent inner ring orifice was found in 10 cases;in the open group,the contralateral inguinal hernia occurred in 3/50 cases after the first operation,which required another surgery for treatment.Compar ed with the open group,the laparoscopic group had significant shorter time of operation,less blood loss,shorter length of stay and less pain(P<0.05).Conclusion Laparoscopic surgery is safe and effective in treatment of incarcerated inguinal hernia in children,with the advantages of short time of operation,less trauma,fast recovery and less pain.It can also detect the closure situation of bilateral inner ring orifice.If the orifice is found patent,high ligation for bilateral internal ring orifice can be performed simultaneously,so as to reduce the risk of secondary operation and anesthesia in children.Therefore,laparoscopic surgery is worthy of clinical promotion.
作者
冯峰
Feng Feng(Department of Minimally Invasive Surgery,Children's Hospital of Hebei Province,Shijiazhuang,Hebei,05000,China)
出处
《西南国防医药》
CAS
2020年第3期203-206,共4页
Medical Journal of National Defending Forces in Southwest China
基金
河北省医学科学研究重点课题(20190791)。
关键词
嵌顿疝
腹腔镜
儿童
incarcerated inguinal hernia
laparoscopic
children
