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中华疝和腹壁外科杂志(电子版) ›› 2019, Vol. 13 ›› Issue (04) : 322 -326. doi: 10.3877/cma.j.issn.1674-392X.2019.04.010

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论著

传统手术与微创手术治疗小儿腹股沟斜疝的疗效
陈继军1, 贾文元1, 赵鹏1, 赵新春1, 李随芬2,()   
  1. 1. 710032 西安,中国人民解放军空军军医大学第一附属医院急诊科
    2. 713700 咸阳,陕西省泾阳县人民医院消化内科
  • 收稿日期:2018-12-05 出版日期:2019-08-18
  • 通信作者: 李随芬

Analysis of the clinical efficacy of traditional surgery and minimally invasive surgery for children with indirect inguinal hernia

Jijun Chen1, Wenyuan Jia1, Peng Zhao1, Xinchun Zhao1, Suifen Li2,()   

  1. 1. Department of Emergency, First Affiliated Hospital of the People's Liberation Army Air Force Military Medical University, Xi'an 710000, China
    2. Department of Gastroenterology, People's Hospital of Shuyang County, Shaanxi 710000, China
  • Received:2018-12-05 Published:2019-08-18
  • Corresponding author: Suifen Li
  • About author:
    Corresponding author: Li Suifen, Email:
引用本文:

陈继军, 贾文元, 赵鹏, 赵新春, 李随芬. 传统手术与微创手术治疗小儿腹股沟斜疝的疗效[J/OL]. 中华疝和腹壁外科杂志(电子版), 2019, 13(04): 322-326.

Jijun Chen, Wenyuan Jia, Peng Zhao, Xinchun Zhao, Suifen Li. Analysis of the clinical efficacy of traditional surgery and minimally invasive surgery for children with indirect inguinal hernia[J/OL]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2019, 13(04): 322-326.

目的

对比分析传统手术与腹腔镜下疝囊高位结扎联合脐正中襞修补治疗小儿腹股沟斜疝的疗效差异。

方法

选取2014年1月至2017年1月,中国人民解放军空军军医大学第一附属医院收治的100例腹股沟斜疝患儿作为研究对象,回顾性分析其临床资料。根据患儿手术方式不同,将其分为试验组及对照组,每组患儿50例。其中试验组采用腹腔镜下疝囊高位结扎联合脐正中襞修补治疗,对照组采用腹腔镜下疝囊高位结扎治疗,比较2组患儿的临床疗效差异。

结果

2组患儿在手术时间、住院时间、术后首次下床活动时间等方面比较,差异均无统计意义(P>0.05);试验组患儿的术后复发率(2.0%)显著低于对照组(16.0%),差异有统计学意义(P<0.05),而在其余并发症方面比较,差异均无统计学意义(P>0.05);与患儿术后复发相关因素包括年龄、术式及内环口直径(P均<0.05);经Logistic回归分析,发现年龄及内环口直径是患儿术后复发的独立危险因素(P均<0.05)。

结论

在保证临床安全及疗效的情况下,腹腔镜下疝囊高位结扎联合脐正中襞修补治疗小儿腹股沟斜疝的术后复发率更低,且年龄及内环口直径是患儿术后复发的独立危险因素,因此在今后的临床工作中,应对此类患儿及早进行干预。

Objective

To explore the difference of curative effect between traditional surgical treatment and laparoscopic high ligation of hernia sac combined with umbilical median hernia repair in children with indirect inguinal hernia.

Methods

A total of 100 children with indirect inguinal hernia in First Affiliated Hospital of the People's Liberation Army Air Force Military Medical University were enrolled in this study. The clinical data were retrospectively analyzed. According to the different surgical treatment methods, the patients were divided into two groups (50 cases each) in the experiment group and the control group, including the study group (using laparoscopic high ligation of the hernia sac combined with umbilical median palpebral repair) and the control group (using laparoscopic high ligation of the hernia sac). To compare the clinical efficacy of the two groups of patients.

Results

There were no statistically differences in the operation time, length of stay, and time of first postoperative activity in the two groups (P>0.05). The postoperative recurrence rate (2.0%) in the experiment group was significantly lower than in the control group (16.0%) (P<0.05), and there was no significant difference between the two groups in the other complications (P>0.05). The factors related to postoperative recurrence included age, surgery and inner ring diameter (both P<0.05); Logistic regression analysis showed that age and internal ring diameter were independent risk factors for postoperative recurrence (P<0.05).

Conclusion

In the case of ensuring clinical safety and efficacy, laparoscopic high ligation of the hernia sac combined with umbilical medial palpebral repair for the treatment of children with indirect inguinal hernia had lower recurrence rate. Age and internal ring diameter were independent risk factors for postoperative recurrence. Therefore, in the future clinical work, such patients should be intervened early.

表1 2组患儿围手术期相关指标比较(±s
表2 2组患儿术后并发症率差异情况[例(%)]
表3 所有患儿术后复发相关影响因素进行单因素分析
表4 所有患儿术后复发相关影响因素进行Logistic回归分析
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