探讨社区医院全科医师对小儿腹股沟疝的检出率及手术方式。

选择2015年2月至2017年1月就诊于太阳宫社区卫生服务中心77例患儿的临床资料，由全科医师行问诊及相关的体格检查得出初步诊断，进一步行超声检查后转诊至上级医院行腹腔镜腹股沟疝疝囊高位结扎术，根据术中诊断回顾性评估社区医院全科医师对小儿腹股沟疝的检出率及社区医院超声诊断准确率，随访术后复发等情况。

77例患儿中，全科医师对小儿腹股沟疝检出率为42.9%，超声诊断准确率为70.1%，并且超声诊断单侧腹股沟疝的54例患儿中，对侧隐匿疝的发生率为35.2%。患儿行腹腔镜腹股沟疝疝囊高位结扎术后均随访6个月，术后阴囊短期内稍水肿，无血肿，无1例复发。

社区医院全科医师对小儿腹股沟疝检出率低，有必要对全科医师行儿童疝和腹壁外科专业培训降低漏诊率。腹腔镜治疗小儿腹股沟疝手术安全可行且可以同时发现对侧病变，降低了漏诊率，避免了二次手术的风险。

To investigate the detection rate of pediatric inguinal hernia by general practitioners in community hospitals, and to analyze the outcome of the surgical treatment of inguinal hernia in children.

Seventy-seven patients who were admitted to the community hospital from February 2015 to January 2017 were selected. The initial diagnosis was made by the general practitioner with inquiry and physical examination. Ultrasound examination was performed and all children was performed laparoscopic inguinal hernia sac high ligation after referral to the superior hospital. Based on intraoperative diagnosis, the detection rate of inguinal hernia by general practitioners in community hospital and ultrasound diagnostic accuracy rate were retrospectively assessed.

Of 77 children, the detection rate of inguinal hernia in children of general practitioners was 42.9%, ultrasound diagnostic accuracy rate was 70.1%, and of the 54 cases which were diagnosed of unilateral hernia with ultrasound, the incidence of contralateral occult inguinal hernia was 35.2%. All cases were followed up for 6 months after surgery, without developing of recurrence and hematoma. The scrotum was slightly edematous in the short term.

The general practitioners in community hospitals have a low detection rate of inguinal hernia in children. It is necessary to provide general practitioners with professional training in hernia and abdominal wall surgery of children to reduce the missed diagnosis rate. Laparoscopic treatment of children with inguinal hernia is safe and feasible. It can detect contralateral occult hernia at the same time, reducing the miss rate and avoiding the risk of secondary surgery.