探究腹腔镜下疝囊高位结扎术与传统疝囊高位结扎术治疗小儿腹股沟疝的疗效。

选取2016年6月至2018年6月，亳州市人民医院106例腹股沟疝患儿的临床资料，随机分为腹腔镜组（53例）和传统手术组（53例）。传统手术组采用传统疝囊高位结扎术进行，而腹腔镜组采用腹腔镜下疝囊高位结扎术。比较2组患儿的手术情况、住院情况、并发症、隐匿性疝、对侧疝突出、复发情况。

腹腔镜组的手术时间、术中出血量、切口长度、术后下床活动时间及术后疼痛时间均低于传统手术组，差异有统计学意义（t=8.574、19.072、58.681、14.511、4.981，P均<0.001）。腹腔镜组住院费用（4 152.85±541.59）元高于传统手术组（3 860.71±459.72）元，差异有统计学意义（t=2.994，P=0.003）；腹腔镜组住院时间（2.07±1.12）d与传统手术组（2.14±1.49）d比较，差异无统计学意义（t=0.273，P=0.785）。腹腔镜组的并发症发生率为7.5%，低于传统手术组30.2%，差异有统计学意义（χ²=8.874，P=0.003）。术后腹腔镜组对侧疝突出的发生率低于传统手术组，差异有统计学意义（0比9.4%，P=0.003）；隐匿性疝发生率显著高于传统手术组，差异有统计学意义（17.0%比0，χ²=5.248，P=0.022）；2组间复发率比较，差异无统计学意义（0比3.8%，χ²=2.038，P=0.153）。

腹腔镜下疝囊高位结扎术治疗小儿腹股沟疝，手术效果较好，可有效缓解患儿术后疼痛，减少并发症的发生，帮助患儿迅速康复，降低医疗成本。

To investigate the efficacy of laparoscopic high ligation of hernia sac and traditional high ligation of hernia sac in the treatment of pediatric hernia.

From June 2016 to June 2018, 106 children with pediatric hernia were randomly divided into the laparoscopic group (53 cases) and the traditional group (53 cases). The traditional operation group was performed with high ligation of hernia sac, while the laparoscopic group with laparoscopic high ligation of hernia sac. The operation, hospitalization, complications, occult hernia, contralateral hernia protrusion and recurrence were compared between the two groups.

The operation time, bleeding volume, incision length, the time of getting out of bed and the time of postoperative pain in the laparoscopic group were significantly lower than those in the traditional group (t=8.574、19.072、58.681、14.511、4.981, all P<0.001). The cost of hospitalization in the laparoscopic group was higher than that of the traditional operation group [(4 152.85± 541.59) yuan vs (3 860.71±459.72) yuan, t=2.994, P=0.003]. There was no significant difference betweenthe laparoscopic group and the traditional surgery group in length of hospitalization [(2.07±1.12) d vs (2.14±1.49) d, t=0.273, P=0.785]. The incidence of complications in laparoscopic group was 7.5%, which was significantly lower than that in traditional operation group (30.2%, χ²=8.874, P=0.003). The incidence of contralateral hernia protrusion in laparoscopic group was lower than that in traditional operation group (0 vs 9.4%, P=0.003), and the incidence of occult herniawere significantly higher than that in traditional operation group (17.0% vs 0, χ²=5.248, P=0.022); There was no significant difference in recurrence rate between the two groups (χ²=2.038, P=0.153).

Laparoscopic high ligation of hernia sac is effective in the treatment of hernia in children. It can effectively relieve the postoperative pain, reduce the occurrence of complications, help the children recover quickly and reduce the medical cost. It is worth popularizing in clinic.