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:探討與行腹腔鏡下疝囊高位結(jié)扎術(shù)斜疝患兒術(shù)后復(fù)發(fā)的因素。方法:收集2013年1月—2016年1月期間行腹腔鏡下疝囊高位結(jié)扎術(shù)的306斜疝患兒臨床資料,對影響患兒術(shù)后復(fù)發(fā)的相關(guān)危險因素進行統(tǒng)計學(xué)分析。結(jié)果:306例患兒(401側(cè))中,13例復(fù)發(fā),復(fù)發(fā)率為3.24%。單變量分析顯示,斜疝患兒的年齡、內(nèi)環(huán)口直徑和結(jié)扎線的選擇與腹腔鏡下疝囊高位結(jié)扎術(shù)術(shù)后復(fù)發(fā)有關(guān)(χ~2=6.275、9.145、11.371,P=0.043、0.010、0.001);多變量Logistic回歸分析顯示,年齡與內(nèi)環(huán)口直徑較大以及用可吸收線結(jié)扎是腹腔鏡下疝囊高位結(jié)扎術(shù)術(shù)后復(fù)發(fā)的獨立危險因素(OR=3.466,95%CI=1.432~8.389;OR=1.988,95%CI=1.237~3.194;OR=1.089,95%CI=1.015~1.168,均P0.05)。結(jié)論:年齡與內(nèi)環(huán)口直徑較大以及可吸收線的使用是導(dǎo)致斜疝患兒行腹腔鏡下疝囊高位結(jié)扎術(shù)術(shù)后復(fù)發(fā)的主要危險因素,對存在危險因素的患兒應(yīng)考慮改良的腹腔鏡手術(shù)方法、加強術(shù)后監(jiān)護,并避免使用可吸收線,減少復(fù)發(fā)的發(fā)生。
[Abstract]:Objective: to investigate the factors of recurrent hernia after laparoscopic high ligation of hernia sac. Methods: the clinical data of 306 children with indirect hernia undergoing laparoscopic high ligation of hernia sac from January 2013 to January 2016 were collected and the risk factors affecting recurrence were analyzed statistically. Results the recurrence rate was 3.24% in 13 out of 306 cases (401 sides). Univariate analysis showed that the age, the diameter of the inner ring and the choice of ligation line were related to the recurrence of high ligation of hernia sac under laparoscope (蠂 ~ 2 / 2 6.275 / 9.145 / 11.371P 0.043 / 0.010 / 0.001), and multivariate Logistic regression analysis showed that there was no significant difference between the two groups. Age, diameter of inner ring and ligation with absorbable line were the independent risk factors of recurrence after laparoscopic high ligation of hernia sac. Conclusion: age, diameter of inner ring and the use of absorbable line are the main risk factors for recurrence of children with indirect hernia after laparoscopic high ligation of hernia sac. The modified laparoscopic operation method should be considered for children with high ligation of hernia sac under laparoscope. Strengthen postoperative monitoring and avoid the use of absorbable lines to reduce recurrence.
【作者單位】： 江蘇省無錫市兒童醫(yī)院小兒外科;
【分類號】：R726.5

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