To analyze the ultrasonic manifestations of congenital diaphragmatic hernia in children and to investigate its diagnostic value.

Between January 2012 and January 2019, 30 children with congenital diaphragmatic hernia admitted to Tunchang people's hospital were selected. Patients were diagnosed with left and right diaphragmatic hernia and hernia contents by ultrasonic and radiological techniques, and the accuracy of the diagnosis of congenital diaphragmatic hernia in children was confirmed by surgery.

The results of the surgery showed that among the 30 children with congenital diaphragmatic hernia, 26 had left hernia and 4 had right hernia. Hernia contents were cavity organs in 9 cases and cavity and substantial organs in 21 cases. The sonographic findings of the children with congenital diaphragmatic hernia were disruption of the diaphragm echo in the upper abdomen, and the lower boundary of the lung was shifted upward. By scanning the back and side of the thorax and waist to isolate the lung, we could see the mixed echo area of the chest cavity which was not connected with other lung tissues. Through the abdominal scan, the cavity organ hernia showed a relatively empty abdominal cavity, substantial organ hernia, and in the normal position it could not show the organ structure. The X-ray findings of the children with congenital diaphragmatic hernia showed a semicircular mass shadow above the diaphragm, the heart and trachea shifted to the healthy side, and the abdomen was relatively empty and dense. The accuracy rate of ultrasonic diagnosis for position of diaphragmatic hernia, and hernia contents (100.00% and 90.00%) was significantly higher than that of X-ray (93.33% and 56.67%, P<0.05).

Ultrasonic diagnosis can estimate the position and contents of congenital diaphragmatic hernia in children through echo and image structure, and its accuracy rate is significantly higher than that of X-ray, which is worthy of clinical promotion.

To investigate the effects of ultrasound-guided transverse abdominis plane block (TAPB) combined with dexmedetomidine (DEX) on anesthetic in elderly patients with inguinal hernia.

A total of 44 elderly patients with indirect inguinal hernia treated in Cangzhou Hospital of Integrated TCM-WM between March 2017 and September 2018 were selected as the research subjects. Random number table method was used to divide them into the control group (n=22) and the observation group (n=22). Tension-free hernia repair was performed in both groups, the control group was given local infiltration anesthesia in surgery, and the observation group was given anesthesia with TAPB and DEX. The anesthesia effects onset time and duration of anesthesia in the two groups were compared. The scores of the nerve block, analgesia and sedation at 2 hours after anesthesia in both groups were compared. The incidence of adverse reactions during the two groups were counted.

The total satisfaction rate of anesthesia effect in the observation group was 95.45%, which was higher than 77.27% in the control group (P<0.05). The onset time of sensory nerve block and motor nerve block in the observation group were shorter than those in the control group, and their durations were longer than those in the control group (P<0.05). At 2 hours after anesthesia, the scores of Bromage and Ramsay in the two groups were not statistically different (P>0.05); the score of Prince-Henry in the observation group was lower than that in the control group (P<0.05). The incidence of adverse reactions in the observation group was 9.09%, which was lower than the 36.36% in the control group (P<0.05).

TAPB combined with DEX has good analgesic effects on elderly patients in inguinal hernia surgery, can improve the effect of anesthesia, and has high safety.

To explore the value of Color Doppler Ultrasound inthe diagnosis and differential diagnosis of round ligament of uterus.

The clinical data and ultrasonographic findings of 105 patients(113 cases) with round ligament lesions diagnosed by Color Doppler Ultrasound in Beijing Chao-Yang Hospital West District from January 2013 to December 2018 were retrospectively analyzed, and compared with surgical and pathological results.

There were 66 patients (69 cases) of round ligament cyst, all of which were complicated with inguinal hernia, Among them, 61 patients (64 cases) were diagnosed correctly by ultrasound. 2 patients (2 cases) with round ligament effusion and round ligament thickening were confirmed as endometriosis with indirect hernia by operation and pathology. 1 patient (1 case) was diagnosed as a varicose veins with indirect hernia by ultrasound, and the varicose veins disappeared after indirect hernia operation.1 patient (1 case) round ligament cyst complicated with hernia was confirmed by operation as indirect hernia with unknown cystic lesion of round ligament.Ultrasound correctly described 21 patients (24 cases) of communicating effusion in round ligament area, all of them proved to be indirect hernia after operation.

Color Doppler Ultrasound is of great value in the diagnosis of round ligament diseases, especially in the diagnosis of round ligament cysts. The incidence of round ligament cyst is relatively high in round ligament diseases.Round ligament disease are closely related to inguinal hernia.

To explore the application value of high frequency color Doppler ultrasound in the diagnosis of linea alba hernia.

From January 2007 to December 2014, The clinical data and sonographic findings of 24 patients in Chinese PLA general hospital with linea alba hernia confirmed by surgery were retrospectively analyzed.

Preoperative high-frequency color Doppler ultrasonography revealed that the site of hernia was located in the midline of the abdominal wall between the xiphoid and the umbilicus. The diameter of the abdominal white line (hernia ring) was about 0.4 to 2.8 cm in diameter. The size was about (1.1 cm×0.3 cm×1.0 cm) to (8.0 cm×3.1 cm×7.2 cm). The shape of the hernia sac was irregular, and the echo in the sac was different because of different contents. It was mainly divided into three categories. The first type of content was extraperitoneal fat, the sonogram showed a relatively uniform or uneven hypoechoic. The second type of content was mainly the omentum, the sonogram showed a moderately low echo. The third type of content was mainly the intestine, and the sonogram was the sac. Intestinal echoes could be seen inside, and their peristalsis could be observed dynamically.

High-frequency color Doppler ultrasound can clearly show the continuity of the abdominal white line, measure the width of the defect, the size of the hernia sac, determine the contents of the hernia, and the presence or absence of incarceration, and have non-invasive, non-invasive, inexpensive. It has good reproducibility and dynamic observation. It owns good sensitivity and specificity for the diagnosis of linea alba hernia, so it is very important for the clinical diagnosis of leucorrhea.

To explore the effect on physiological parameters of children with inguinal hernia surgery by using ultrasound-guided ilioinguinal-iliohypogastric nerve block (IINB) and general anesthesia.

From February 2017 to October 2018, 110 children undergoing open high ligation of hernial sac for inguinal hernia surgery in PLA Airborne Army Hospital were randomly divided into the control group and the observation group, with 55 cases in each group. The control group was treated with general anesthesia only, while the observation group was treated with INNB on the basis of the control group. The operation conditions, adverse reactions and physiological parameters, the level of immune stress were observed and compared between the two groups.

The incidence of adverse reactions was 10.91% (n=6) in the observation group and 7.72% (n=4) in the control group, and there was no significant difference between the two groups (P>0.05). There was no significant difference in retention time in postoperative anesthesia recovery room after operation, recovery time and operation time between the two groups (P>0.05). The levels of the heart rate and mean arterial pressure of the children in the observation group were lower than those in the control group at the time to wake up and 6 hours after operation (P<0.05). The levels of cortisol and interleukin-6 in the observation group were lower than those in the control group when waking up and 6 hours after operation (P<0.05).

On the basis of general anesthesia, combined with ultrasound-guided IINB will not increase the incidence of postoperative adverse reactions in children with inguinal hernia surgery, but its postoperative stress response has little influence and the vital signs of children are more stable.

To evaluate the value of ultrasound-guided drug injection in the treatment of pain complications after inguinal hernia surgery.

From June 2018 to August 2019, 15 patients who could not relieve the pain after inguinal hernia operation were treated by injecting medicine into the soft tissue area around the iliohypogastric nerve, ilioinguinal nerve and genitourinary branch of genitourinary nerve under the guidance of ultrasound. The visual analogue scale (VAS) was used to evaluate the pain relief before and at 24 hours, 48 hours, 2 weeks and 4 weeks after operation.

After the drug injection under the guidance of ultrasound, the pain was relieved in a short period of time, especially in 24 hour. There was no significant difference in VAS score between 2 weeks and 4 weeks after block operation (P>0.05). There was significant difference in other groups (P<0.05).

Ultrasound-guided drug injection therapy can relieve the pain after inguinal hernia operation effectively in a short time, and the clinical effect is remarkable. Therefore, it should be used as a safe and effective method to relieve the pain after inguinal hernia operation.

To explore the effect of ultrasound-guided transverse abdominal planar block (TAPB) combined with laryngeal mask ventilation general anesthesia in pediatric indirect inguinal hernia surgery.

100 children with indirect inguinal hernia who underwent high ligation of hernia sac in Chengdu Women's & Children's Central hospital from January 2018 to October 2018 were selected and divided into control group (n=50) and observation group (n=50) according to random number table method. The control group was given laryngeal mask ventilation general anesthesia during operation, while the observation group was given ultrasound-guided TAPB combined with laryngeal mask ventilation general anesthesia during operation. The operation related indexes, hemodynamic indexes, FLACC and adverse reactions were observed in the two groups.

The extubation time, anesthesia recovery time and hospitalization time in the observation group were significantly shorter than those in the control group [(6.27±1.86) minutes vs (13.31±2.05) minutes; (13.34±3.17) minutes vs (19.86±3.48) minutes; (2.26±0.14) days vs (3.15±1.17) days, P<0.05]. Compared with T1 period, HR, SBP and DBP in T2 and T3 period of observation group had no significant difference (P>0.05), HR in control group had no significant difference (P>0.05), and SBP and DBP increased gradually (P<0.05). HR in T1 period in observation group was not significantly different from that in control group (P>0.05), but in T2 and T3 period in observation group was significantly lower than that in control group (P<0.01). There was no significant difference in SBP and DBP in T1 period between the observation group and the control group (P>0.05), but in T2 and T3 period, SBP and DBP in the observation group were significantly lower than those in the control group (P<0.01). The FLACC scores of the two groups decreased gradually at the time of awakening, 2 h, 4 h and 8 h after operation (2.3±0.6, 2.0±0.4, 1.6±0.5, 1.2±0.3, respectively), and the observation group was significantly lower than the control group (3.0±0.5, 2.7±0.6, 2.2±0.3, 1.7±0.4, P<0.05). The incidence of vomiting, sore throat and laryngeal spasm in the observation group was lower than that in the control group (6.00% vs 20.00%, 6.00% vs 22.00%, 4.00% vs 18.00%, P<0.05).

Ultrasound-guided TAPB combined with laryngeal mask ventilation general anesthesia can better maintain the stability of hemodynamics and reduce the incidence of pain and adverse reactions in children with high ligation of hernia sac, which is worthy of clinical application.

To explore the analgesic effect of ultrasound guided transverse abdominis plane block combined with laryngeal mask general anesthesia on high ligation of hernia sac in children.

150 children undergoing high ligation of hernia sac were randomly divided into the observation group (75 cases) and the control group (75 cases). The control group was treated with laryngeal mask general anesthesia, while the observation group was treated with ultrasound guided transverse abdominis plane block on the basis of the control group. The mean arterial pressure (MAP), heart rate (HR), restlessness and pain scores, recovery time, operative time and complications were compared between the two groups.

The incidence of complications in the observation group was significantly lower than that in the control group (6.7% vs 17.3%, P<0.05). The operation time, recovery time, restlessness score and 12 h FLACC score in the observation group were lower than those in the control group (P<0.05). In the observation group, there was no significant difference in MAP, HR when the laryngeal mask was inserted, the surgery start time, the laryngeal mask was removed and before anesthesia induction (P>0.05). In the control group, there was no significant difference in MAP, HR when the laryngeal mask was inserted, the laryngeal mask was removed and before anesthesia induction (P>0.05). The MAP, HR at the beginning of operation in the control group was higher than that before anesthesia induction (P<0.05). There was no significant difference in MAP, HR between the two groups (P>0.05) when period before anesthesia induction, the laryngeal mask was inserted ,and after inserting laryngeal mask. At the beginning of operation, the MAP, HR of the observation group was lower than that of the control group (P<0.05).

Ultrasound-guided transverse abdominis plane block combined with laryngeal mask general anesthesia in high ligation of hernia sac in children can effectively reduce the operation time and postoperative recovery time, relieve postoperative pain and restlessness, and reduce the incidence of complications. It has great clinical application value.

To explore the application effect of ultrasound guided transversus abdominis plane (TAP) block in children with inguinal hernia repair.

The clinical data of 108 children who underwent inguinal hernia repair in First People's Hospital of Jingzhou between March 2017 and September 2018 were retrospectively analyzed. They were divided into the experiment group (n=63) and the control group (n=45) according to the different anesthesia methods. The control group used conventional anesthesia, the experiment group used ultrasound guided TAP block. The situation of surgical stress reaction, the postoperative recovery time, extubation time, the situation of agitation and self-controlled analgesia were compared between the two groups, and the complications of the two groups were recorded.

The heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) at 2 minutes and 10 minutes after incision in the experiment group were significantly lower than the control group (P<0.05). Compared with the control group, the postoperative recovery time and extubation time of the experiment group significantly advanced (P<0.05). The pediatric anesthesia emergence delirium (PAED) score at 10 minutes after extubation in the experiment group was significantly lower than that of the control group (P<0.05). Compared with the control group, the amount of self-controlled analgesia 24 hours after operation significantly reduced, and the count of analgesic pump compressions significantly decreased in the experiment group (P<0.05). The incidence of total complications in the experiment group was significantly lower than that in the control group (P<0.05).

Ultrasound guided TAP block is effective in children with inguinal hernia repair, which can effectively reduce the risk of agitation during recovery and surgical stress in children. The complications of post-operation are less, and the safety is high. The postoperative recovery is faster, it is worthy of clinical application.

To compare and analyze the clinical value of Ultrasonic Volume Auto-scan (UVAS) and traditional ultrasound in the diagnosis of abdominal external hernia, so as to provide evidence for the diagnosis and prognosis of abdominal hernia.

A retrospective analysis was conducted on 120 patients who was considered the diagnosis of abdominal hernia patients in Maternal and Child Health Hospital of Shiyan from January 2015 to July 2016. UVAS and conventional ultrasonography were performed, respectively. The parts of the three-dimensional structure, retraction path, specific location, hernia sac and hernia contents were analyzed to determine the type of the hernia. Preoperative and postoperative diagnosis results of the two examination methods were compared and analyzed.

Compared with traditional ultrasound, UVAS had advantages in diagnosing and typing abdominal external hernia, especially for abdominal wall incisional hernia and irreducible inguinal hernia, because it could display coronal images of tissues.

UVAS provides three-dimensional images for clinical workers to diagnose abdominal external hernia. Compared with traditional ultrasound examination, it has better clinical value and is worthy of further promotion.

Chronic pain as a complication following inguinal herniorrhaphy has attracted increasing attention in recent years. There is evidence that chronic pain seriously affects patients' quality of life. However, there are few studies and data regarding imaging-based diagnosis of the etiology of chronic pain. Objective To explore the etiology as well as to analysis ultrasonographic imaging description of chronic pain following anterior open inguinal herniorrhaphy.

Ultrasonography was performed on 164 sites at which chronic pain was felt following anterior open inguinal herniorrhaphy to identify the main causes of the chronic postoperative pain. Positive ultrasound findings which appeared at the same time were grouped for comparisons.

There are positive ultrasound diagnoses of chronic postoperative pain: encapsulated effusion, edema of the scrotal wall, testitis, hydrocele testis, limited motion of the spermatic cord at the reconstructed deep inguinal ring, varicocele, scar hyperplasia at pubic sutures, mesh shrinkage, patch or mesh plug accumulation, recurrent hernia, spermatic cord cyst as well as cyst of the caput epididymis. In terms of the pairwise merge of positive ultrasound diagnoses, there were significant differences between the respective groups in encapsulated effusion with scrotal wall edema, varicocele with limited motion of the spermatic cord at the reconstructed deep inguinal ring, and mesh shrinkage with recurrent hernia (χ²=41.37、20.07、13.19、7.36, P<0.05).

Ultrasonography offer important benefits in the diagnosis of chronic pain following anterior open inguinal herniorrhaphy. Some positive findings cause chronic pain at the same time, which is necessary for doctors to consider comprehensively while making a diagnosis.