本文選題：疝 + 腹股溝��； 參考：《中國普通外科雜志》2017年10期

【摘要】：目的:探討自制穿刺帶線針輔助單孔腹腔鏡下疝囊高位結(jié)扎術中治療小兒腹股溝疝的可行性與療效。方法:回顧性分析2012年1月—2014年11月期間收治的47例小兒腹股溝疝患者資料,其中23例行自制穿刺帶線針輔助單孔腹腔鏡下疝囊高位結(jié)扎術(腹腔鏡組),采用全身麻醉;24例行傳統(tǒng)開放性疝囊高位結(jié)扎術(開放組),采用連續(xù)硬膜外麻醉。比較兩組患者的相關臨床指標。結(jié)果:腹腔鏡手術均獲成功,無中轉(zhuǎn)開腹。與開放組比較,腹腔鏡組手術時間縮短(8.26 min vs.36.54 min),術中出血量降低(0.63 m L vs.4.15 m L)、術后住院時間減少(1.39 d vs.3.75 d),但住院費用增加(6 682.18元vs.4 385.93元),差異均有統(tǒng)計學意義(均P0.05);腹腔鏡組無術后并發(fā)癥,開放組術后發(fā)生并發(fā)癥5例,其中陰囊血腫3例,皮下血腫2例,兩組總并發(fā)癥發(fā)生率差異有統(tǒng)計學意義(0 vs.20.8%,P0.05)。兩組隨訪期間均無復發(fā)病例。結(jié)論:自制穿刺帶線針輔助下單孔腹腔鏡治療小兒腹股溝疝安全有效、具有微創(chuàng)、無明顯瘢痕、并發(fā)癥少等優(yōu)點。
[Abstract]:Objective: to investigate the feasibility and effect of self-made puncture with wire needle and single-hole laparoscopic high ligation of hernia sac in the treatment of inguinal hernia in children. Methods: the data of 47 children with inguinal hernia from January 2012 to November 2014 were retrospectively analyzed. 23 cases were treated with self-made puncture and wire needle assisted laparoscopic high ligation of hernia sac (laparoscopic group), 24 cases of traditional open hernia sac high ligation (open group, continuous epidural anesthesia). To compare the related clinical indexes between the two groups. Results: all the laparoscopic operations were successful, and there was no conversion to open operation. Compared with the open group, In the laparoscopic group, the operative time was shortened by 8.26 min vs.36.54, the blood loss decreased by 0.63 mL / mL, and the postoperative hospitalization time decreased by 1.39 days, but the hospitalization cost increased by 6 682.18 yuan vs.4 385.93 yuan, the difference was statistically significant (all P 0.05), there were no postoperative complications in the laparoscopy group. In the open group, there were 5 cases of postoperative complications, including 3 cases of scrotal hematoma and 2 cases of subcutaneous hematoma. There was a statistically significant difference in the incidence of total complications between the two groups (P 0.05). No recurrence occurred during follow-up in both groups. Conclusion: single hole laparoscopy with wire needle is safe and effective in the treatment of inguinal hernia in children. It has the advantages of minimally invasive, no obvious scar and less complications.
【作者單位】： 包頭醫(yī)學院第一附屬醫(yī)院普外科一病區(qū);內(nèi)蒙古包頭市疾病預防控制中心;
【基金】：內(nèi)蒙古自治區(qū)科學技術廳科技計劃資助項目(201502080)
【分類號】：R726.5

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