摘要
目的分析青少年腹股沟疝的临床特点,探讨合理的修补术式。方法回顾性分析2010年1月至2019年1月在四川大学华西医院接受疝修补术的170例14~18岁腹股沟疝病人的临床资料。分析手术方式、麻醉方法、手术时间、医疗费用、复发和并发症发生情况。结果 170例病人中应用传统缝合法行Bassinni手术者16例,应用网塞修补者11例,应用平片法行Lichtenstein手术者3例,行腹腔镜TAPP者3例,应用腹膜前间隙修补法者137例。3例TAPP术式病人采用全麻,5例病人采用持续硬膜外麻醉,162例病人采用局部浸润麻醉,手术时间(28.5±11.6)min。术后中位住院时间1 d,其中日间手术159例,占93.5%。医疗总费用单侧腹股沟疝(7254.8±236.5)元,双侧腹股沟疝(13261.9±543.8)元。随访率为95%,随访时间5~113个月,无复发病人。1例双侧隐睾病人出现生育障碍,2例病人出现慢性疼痛,余未出现严重并发症。结论青少年腹股沟疝应选择个体化治疗方案。
Objective To analyze the clinical characteristics of adolescent inguinal hernia,and to explore the reasonable repair methods.Methods The clinical data of 170 cases of adolescent aged between 14 to 18 years old with inguinal hernia admitted from January 2010 to January 2019 in West China Hospital of Sichuan University were analyzed retrospectively.The operation mode,anesthesia method,operation time,medical expenses,recurrence and complications were studied.Results Among the 170 patients,16 patients were treated with traditional suture repairing Bassini method,11 patients were treated with mesh plug repair,3 patients were treated with plain film Lichtenstein method,3 patients were treated with TAPP,and preperitoneal space repair was applied in 137 cases.Three patients with TAPP were treated with general anesthesia,5 patients underwent continuous epidural anesthesia,and 162 patients underwent local infiltration anesthesia.The average operation time was(28.5±11.6)minutes.The median postoperative hospital stay was 1 day,including 159 cases(93.5%)of day surgery.The total cost of medical treatment was(7254.8±236.5)yuan per unilateral inguinal hernia,and the bilateral inguinal hernia was(13261.9±543.8)yuan.The follow-up rate was95%,and the follow-up time was 5 to 113 months.There was no recurrence.One patient with bilateral cryptorchidism developed fertility disorder,and two patients developed chronic pain.No serious complication occurred in remaining patients.Conclusion Adolescent inguinal hernia should be selected from the individualized treatment plan.
作者
宋应寒
张森
简福顺
Gonish Hada
彭雪峰
雷文章
SONG Ying-han;ZHANG Sen;JIAN Fu-shun;Gonish Hada;LEI Wen-zhang(Department of Day Surgery and Gastrointestinal Surgery,West China Hospital of Sichuan University,Chengdu 610041,China)
出处
《中国实用外科杂志》
CSCD
北大核心
2019年第8期829-831,共3页
Chinese Journal of Practical Surgery
基金
国家自然科学基金青年基金项目(No.71804117)
