改良小儿腹腔镜下腹股沟疝疝囊高位结扎术的临床应用
Application of Improved Micro-laparoscopic High Ligation in Pediatric Inguinal Hernia
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摘要: 目的 对比改良小儿腹腔镜疝囊高位结扎术与传统疝囊高位结扎术对小儿疝的治疗效果.方法 回顾性分析文山州医院2013年1月至2014年12月诊断为腹股沟疝的儿童(年龄8个月~14岁)200例,随机分成观察组和对照组各100例,分别实施改良小儿腹腔镜疝囊高位结扎术和传统术式.手术时记录2组术中失血量、术口长度、手术时间.术后记录住院时间、疼痛时间、总费用.随访6个月观察复发率、并发症.对2组治疗效果进行综合分析比较.结果 观察组较对照组手术切口小,失血少,术后疼痛轻,手术时间短,住院时间短,复发率低,2组比较差异均有统计学意义(P<0.05).结论 小儿腹股沟疝,改良小儿腹腔镜腹股沟疝囊高位结扎术较传统术式疗效好,并发症低,预后好,是比较理想的术式.Abstract: Objective To compare the treatment effects between improved micro-laparoscopic hernia sac high ligation and traditional hernia sac high ligation. Methods Retrospective analysis was conducted. A total of 200 pediatric patients diagnosed with inguinal hernia in our hospital from 2013 to 2014,ranging in age from 8 months to14 years, were enrolled and divided into observational group and control group(n=100) The two groups received improved-micro-laparoscopic hernia sac high ligation and traditional hernia sac high ligation respectively. We recorded intraoperative blood loss, operative incision length and operation time during the operation, and hospitalization time,pain time and total cost after the operation. Recurrence rate and complication were followed up for 6 months. Treatment effects were compared between these two groups. Results Smaller incision length, less blood loss and postoperative pain, shorter operative time and hospitalization time and lower recurrence rate were found in observational group and they were of statistical significance(P<0.05). Conclusion Improved-microlaparoscopic hernia sac high ligation for pediatric inguinal hernia shows better treatment effect, lower recurrence rate and better prognosis and it is an ideal approach.
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[1] [1]WUIKAN M L,WIENER E S,VANBALENV,et al.Laparoscopy through the open ipsilateral sac to evaluate presense of contralateral hernia[J].J Pediatr Surg,1996,31(8):1174-1177. [2]姚干,杨庆堂,张庆峰,等.微型腹腔镜治疗小儿腹股沟斜疝6100例报告[J].腹腔镜外科杂志,2011,16(1):18-20. [3] [3]GISEKE S,GLASS M,TAPADAR P.et al.A true laparoscopic hernioterny in children:Evaluation of long-term outcome[J]J laparoendosc Advsurg Tech A,2010,20(2):191-194. [4]吴在德,吴肇汉.外科学[M].第6版.北京:人民卫生出版社,2003:413. [5]谭家驹.微创外科手术与麻醉[M].北京:科学技术文献出版社,2003:227. [6]朱云祥,叶启发,倪庆,等.疝环充填式无张力疝修补术术后疼痛的防治体会[J].实用临床医药杂志,2007,11(4):112-115. [7]于波,李胜利,宁景志,等.腹腔镜下小儿腹股沟疝内环高位结扎术的临床研究[J].中国妇幼健康研究,2013,24(4):573-575. [8]李宇洲,梁健升,刘衍民.微型腹腔镜治疗小儿斜疝350例[J].中华小儿外科杂志,2002,23(1):63-64. [9] 杨庚生,李虹,谢孔伦,等.经脐单孔腹腔镜治疗儿童腹股沟疝的430例临床报告[J].医学信息,2014,10(22):631. [10]李炳根,聂向阳.儿童腹股沟疝的腹腔镜手术治疗进展[J].中华外科杂志,2013,51(4):328-330. [11]杨继碧.附脐静脉解剖学观测[J].四川解剖学杂志,2006,14(3):65-78. [12] [12]CHEAHWK,SOJB,LOMANTOD.Endoscopicextraperitoneal inguinal hernia repair:a series of 182 repairs[J].Singapore Med J,2004,45(6):267-270. [13]王果,李振东.小儿外科手术学[M].北京:人民卫生出版社,2000:393-400. [14] [14]GORSLERCM,SCHIERF.Laparoscopicherniorrhaphy in children[J].Surg Endosc,2003,17(4):571-573. [15]陈荣海,马桂桃.腹腔镜手术与传统手术治疗小儿腹股沟斜疝的临床分析[J].河北医学,2011,17(3):379-381. [16] 卢安平.微创手术治疗小儿腹股沟斜疝150例体会[J].中国医学创新,2011,8(32):122-123. [17]李正,王慧兰,吉士俊.实用小儿外科学[M].北京:人民卫生出版社,2001:53l-535. [18]徐江,张静.腹腔镜胆囊切除术围手术期的护理[J].西南军医,2007,9(5:):123-124. [19]胡明,严志龙.经脐单切口腹腔镜下儿童腹股沟疝高位结扎术[J].中国微创外科志,2014,12(10):912-913,916. [20]刘传荣,骆福裕,李伟俊,等.腹腔镜下手法复位+内环结扎术治疗小儿嵌顿疝临床分析[J].江西医药,2016,15(8):738-739. [21]吴平辉,徐芳,王小农,等.硬膜外穿刺针在腹腔镜治疗小儿腹股沟斜疝的应用[J].江西医药,2013,48(10):911. [22]张柏,邵影,刘树立,等.单孔腹腔镜手术治疗小儿腹股沟疝(鞘膜积液)[J].中国微创外科杂志,2012,12(5):438-440. -
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