腹腔镜疝囊高位结扎联合脐正中襞覆盖内环治疗小儿腹股沟斜疝的疗效

doi:10.3877/cma.j.issn.1674-392X.2019.03.011

目的

探讨腹腔镜疝囊高位结扎联合脐正中襞覆盖内环治疗小儿腹股沟斜疝的临床效果。

方法

选取2016年3月至2018年5月，太和县人民医院就诊的74例腹股沟斜疝患儿为研究对象，回顾性分析其临床资料。依据患儿所行手术的不同进行分组，行腹腔镜疝囊高位结扎术者为对照组（36例），观察组（38例）在对照组的基础上联合脐正中襞覆盖内环手术治疗，2组均于术后定期随访3个月。比较2组手术相关指标，如手术时间、术中出血量、术后住院时间等；记录术后随访期间2组并发症发生情况及复发情况。

结果

观察组手术时间、术后住院时间、术中出血量与对照组比较，差异均无统计学意义（P>0.05）。术后随访期间观察组并发症总发生率显著低于对照组，差异有统计学意义（P<0.05），观察组与对照组复发率比较，差异无统计学意义（P>0.05）。

结论

腹腔镜疝囊高位结扎联合脐正中襞覆盖内环治疗小儿腹股沟斜疝的临床效果优于传统手术，术后患儿康复较好，并发症发生率较低。

关键词: 腹腔镜疝囊高位结扎, 脐正中襞覆盖内环, 腹股沟斜疝, 小儿, 疗效

Objective

To explore the clinical effect of laparoscopic high ligation of hernia sac combined with medial umbilical fold covering inner ring in the treatment of indirect inguinal hernia in children.

Methods

The clinical data of 74 children with indirect inguinal hernia in Taihe County People's Hospital from March 2016 to May 2018 were retrospectively analyzed. According to the different operation of the children, the patients undergoing laparoscopic high ligation of hernia sac were selected as the control group (n=36) and the observation group (n=38) combined with the operation of the umbilical median fold covering inner ring on the basis of the control group, the 2 groups were regularly followed up for 3 months after operation. The operation related indexes, such as operation time, intraoperative bleeding volume, and postoperative hospitalization time of the 2 groups were compared, and the occurrence and recurrence of complications in the 2 groups during the follow-up period were recorded.

Results

There was no significant difference in operation time, postoperative hospitalization time and intraoperative bleeding between the observation group and the control group (P>0.05). The total incidence and recurrence rate of complications in the observation group were significantly lower than those in the control group during the follow-up period (P<0.05), there was no significant difference in recurrence rate between the observation group and the control group (P>0.05).

Conclusion

The clinical effect of laparoscopic high ligation of hernia sac combined with umbilical median fold covering inner ring in the treatment of indirect inguinal hernia in children is better than that of traditional operation. The postoperative recovery of the children is better, and the incidence of complications is lower.

Key words: Laparoscopic high ligation of hernia sac, Median umbilical fold covering inner ring, Indirect inguinal hernia in children, Clinical effect

表1 2组手术相关指标比较（±s）

组别	例数	手术时间(min)	术中出血量(ml)	住院时间(d)
观察组	38	25.42±4.69	20.15±5.20	2.33±0.79
对照组	36	23.75±5.62	19.03±6.54	2.40±0.73
P值		>0.05	>0.05	>0.05

表1 2组手术相关指标比较（±s）

组别	例数	手术时间(min)	术中出血量(ml)	住院时间(d)
观察组	38	25.42±4.69	20.15±5.20	2.33±0.79
对照组	36	23.75±5.62	19.03±6.54	2.40±0.73
P值		>0.05	>0.05	>0.05

[1]	惠远见，周勤慧，狄茂军, 等. 单孔腹腔镜疝囊高位结扎术治疗小儿腹股沟斜疝的疗效[J]. 中华实用儿科临床杂志, 2015, 30(17): 1353-1354.
[2]	Xiang B, Jin S, Zhong L, et al. Reasons for recurrence after the laparoscopic repair of indirect inguinal hernia in children[J]. J Laparoendosc Adv Surg Tech A, 2015, 25(8): 681-683.
[3]	祝华义. 小儿腹股沟疝治疗新进展[J]. 医学理论与实践, 2014, 27(3): 315-317.
[4]	张会迎，林忠亮. 腹腔镜疝囊高位结扎加脐内侧襞修补手术在大龄儿童腹股沟斜疝中的应用[J]. 中国实用医药, 2018, 13(14): 70-72.
[5]	鲍润贤. 成人腹股沟疝造影:方法,正常解剖及疝的诊断标准[J]. 国际医学放射学杂志, 1982, 10(5): 295-296.
[6]	Yin Y, Zhang H, Zhang X, et al. Laparoscopic surgery in the treatment of incarcerated indirect inguinal hernia in children[J]. Exp Ther Med, 2016, 12(6): 3553-3556.
[7]	Pogorelić Z, Rikalo M, Jukić M, et al. Modified Marcy repair for indirect inguinal hernia in children: a 24-year single-center experience of 6826 pediatric patients[J]. Surg Today, 2016, 47(1): 1-6.
[8]	张小桥，吉棚. 腹腔镜腹股沟疝修补术后复发的原因与对策[J]. 国际外科学杂志, 2015, 42(10): 694-696.
[9]	Burcharth J. The epidemiology and risk factors for recurrence after inguinal hernia surgery[J]. Dan Med J, 2014, 61(5): B4846.
[10]	周晓波，段永福，赵成鹏, 等. 腹腔镜疝囊高位结扎加脐正中襞修补手术在小儿腹股沟斜疝中的应用[J]. 中国微创外科杂志, 2016, 16(12): 1121-1124.
[11]	朱利民，黄河，王艳杰, 等. 腹腔镜疝囊高位结扎联合脐内侧襞覆盖内环口治疗小儿腹股沟疝的疗效观察[J]. 实用临床医药杂志, 2015, 19(9): 120-121.
[12]	贺轲，向国安，夏正林, 等. 经脐两孔法腹腔镜腹股沟疝内环高位结扎加脐外侧襞加强术治疗小儿腹股沟斜疝(附108例报告)[J]. 腹腔镜外科杂志, 2016, 21(12): 932-935.
[13]	杨喜光，陈小勋，张达, 等. 腹腔镜疝囊高位结扎及脐内侧襞加强修补腹股沟疝的实验研究[J]. 中国普通外科杂志, 2015, 24(12): 1722-1726.

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Clinical effect of laparoscopic high ligation of hernia sac combined with medial umbilical fold covering inner ring in the treatment of indirect inguinal hernia in children

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Clinical effect of laparoscopic high ligation of hernia sac combined with medial umbilical fold covering inner ring in the treatment of indirect inguinal hernia in children