摘要
目的分析小儿腹股沟斜疝腹腔镜术后复发情况,调查可能导致复发的影响因素,指导未来该类疾病术后复发的防治。方法选取2017年7月-2019年7月在该院完成腹腔镜手术治疗与术后随访的260例腹股沟斜疝患儿的病历资料,采用自制调查表收集患儿基础资料,分析患儿术后复发情况,经单因素、多因素分析找出患儿术后复发的影响因素。结果260例腹股沟斜疝患儿经脐单部位腹腔镜手术后15例复发,复发率为5.77%;初步经单因素检验结果显示,年龄、病程均与腹股沟斜疝腹腔镜手术后复发无关(P>0.05);男性、双侧发病、确切高位结扎、疝后壁腹膜松弛、疝囊结扎线脱落、腹外斜肌筋膜误扎、巨大疝、环扎、术后过早下床活动均可能是术后复发的影响因素(P<0.05);经Logistic多因素回归分析结果显示,男性、双侧发病、疝后壁腹膜松弛、疝囊结扎线脱落、腹外斜肌筋膜误扎、巨大疝、术后过早下床活动是腹股沟斜疝腹腔镜手术后复发的危险因素(OR>1,P<0.05);确切高位结扎、环扎是其保护因素(OR<1,P<0.05)。结论小儿腹股沟斜疝腹腔镜手术后易受较多因素影响增加复发风险,如性别、发病部位、疝后壁腹膜松弛等,对于有这类风险因素的患儿,应及时采取合理干预,以减少复发;而确切高位结扎、环扎可能是其保护因素,若患儿条件允许、符合相关指征,可考虑给予高位结扎或环扎,以降低术后复发风险。
Objective To analyze the recurrence after indirect inguinal hernia laparoscopic surgery,survey the influencing factors of recurrence,direct prevention and treatment of recurrence.Methods The data of 260 children with indirect inguinal hernia treated by laparoscopic surgery and followed up in Taizhou Hospital from July 2017 to July 2019 were selected,a self-designed questionnaire was used to collect the basic data,the recurrence was analyzed,the influencing factors of recurrence were analyzed by univariate analysis and multivariate analysis.Results Among 260 children after indirect inguinal hernia laparoscopic surgery,occurrence was observed in 15 children,the recurrence rate was 5.77%.Univariate analysis showed that age and course of disease were not correlated with recurrence after indirect inguinal hernia laparoscopic surgery(P>0.05).Male,bilateral lesions,exact high ligation,loose hernia back wall peritoneum,deciduous ligature,incorrect ligation of fascia of musculus obliquus externus abdominis,large inguinal hernia,circumferential wiring,and too early off-bed activity were influencing factors of recurrence after indirect inguinal hernia laparoscopic surgery(P<0.05).Logistic multivariate regression analysis showed that male,bilateral lesions,loose hernia back wall peritoneum,deciduous ligature,incorrect ligation of fascia of musculus obliquus externus abdominis,large inguinal hernia,and too early off-bed activity were influencing factors of recurrence after indirect inguinal hernia laparoscopic surgery(OR>1,P<0.05),exact high ligation and circumferential wiring were protective factors of recurrence after indirect inguinal hernia laparoscopic surgery(OR<1,P<0.05).Conclusion After indirect inguinal hernia laparoscopic surgery,recurrence is affect by many factors,such as gender,site of pathological changes,loose hernia back wall peritoneum,and so on,for these children with risk factors,reasonable intervention should be taken to reduce recurrence;exact high ligation and circumferential wiring are the protective fa
作者
单王永
洪盾
SHAN Wang-Yong;HONG Dun(Taizhou Hospital Affiliated to Wenzhou Medical University,Taizhou,Zhejiang 317000,China)
出处
《中国妇幼保健》
CAS
2020年第22期4352-4355,共4页
Maternal and Child Health Care of China
关键词
腹股沟疝
斜疝
腹腔镜
复发
影响因素
Inguinal hernia
Indirect hernia
Laparoscope
Recurrence
Influencing factor
