经脐单孔腹腔镜治疗儿童腹股沟疝的临床疗效分析

陈芳芳; 付晓君; 姜磊; 王超; 汪宇

doi:10.16766/j.cnki.issn.1674-4152.002978

经脐单孔腹腔镜治疗儿童腹股沟疝的临床疗效分析

doi: 10.16766/j.cnki.issn.1674-4152.002978

蚌埠医学院第一附属医院普外科, 安徽蚌埠 233004

基金项目:

安徽省自然科学基金面上项目 82070561

蚌埠医学院自然科学重点项目 2021byzd129

详细信息

通讯作者:
汪宇, E-mail: 450324224@qq.com

中图分类号: R656.21
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出版历程
- 收稿日期: 2022-05-16

Clinical efficacy of transumbilical single-port laparoscopic treatment of inguinal hernia in children

Department of General Surgery, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China

摘要

摘要: 目的对经脐单孔腹腔镜疝囊高位结扎术治疗小儿腹股沟疝中一种新的套线方式的临床疗效进行探讨，并进行安全性评价。方法选取蚌埠医学院第一附属医院于2020年8月—2021年8月期间收治的腹股沟斜疝病例220例，其中接受单孔腹腔镜治疗的116例腹股沟疝患儿作为观察组，采用双孔腹腔镜手术治疗的104例腹股沟疝患儿作为对照组。对在术中、术后、围手术期2组患儿的不良反应及远期复发状况进行比较。结果 (1) 患儿基本资料比较：在年龄、性别、发病部位等一般资料上，2组患儿之间差异无统计学意义(均P>0.05)；(2)患儿手术基本状况比较：在术中出血量、手术时长上，2组患儿之间差异无统计学意义(均P>0.05)；在手术花费、术后住院时长上，2组患者之间差异有统计学意义(均P < 0.05)。(3)围手术期不良反应：在术后阴囊水肿、发热反应上，2组患儿之间差异无统计学意义(均P>0.05)；在术后不良切口反应上，2组患者之间差异有统计学意义(P < 0.05)。(4)复发情况：对出院后2组患儿进行随访，时长为6个月，结果显示观察组患儿无复发，对照组有1例复发(0.96%)；在复发率上，2组患儿之间差异无统计学意义(P>0.05)。结论在单孔腹腔镜治疗小儿腹股沟疝中，新的套线方式安全有效，具有推广价值。
- 经脐单孔腹腔镜 /
- 腹股沟疝 /
- 雪橇针
Abstract: Objective To evaluate the clinical efficacy and safety of a new threading technique in the treatment of inguinal hernia in children by transumbilical single-port laparoscopic high ligation. Methods This research used a retrospective cohort study. A total of 220 cases of inguinal hernia treated at the First Affiliated Hospital of Bengbu Medical College from August 2020 to August 2021 were selected, including 116 cases of inguinal hernia treated by single-port laparoscopy as the observation group, and 104 cases of inguinal hernia treated by double-port laparoscopy as the control group. The intraoperative, postoperative and perioperative adverse reactions and long-term recurrence were compared between the two groups. Results (1) Comparison of baseline data: there were no significant differences in gender, age, location of disease and other general data between the two groups (all P>0.05); (2) Comparison of basic conditions of surgery: there were no significant differences in surgical duration and intraoperative blood loss in the observation group (all P>0.05); length of hospital stay and surgical cost were significantly different between the two groups (all P < 0.05). (3) Perioperative adverse reactions: there were no significant differences in postoperative fever and scrotal edema between the two groups (all P>0.05). There were significant differences in postoperative incisional adverse reactions (P < 0.05). (4) Recurrence: patients in the two groups were discharged from hospital and followed up for 6 months. The results showed that there was 1 case of recurrence in the control group (0.96%). There was no recurrence case in the observation group. There was no significant difference in the recurrence rate between the two groups (P>0.05). Conclusion Single-port laparoscopic treatment of inguinal hernia in children using a new threading technique is clinically safe and effective and worth promoting.
- Transumbilical single-port laparoscope /
- Inguinal hernia /
- Sledge needle
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图 1 两孔脐部穿刺方法及雪橇针带线图

注：A示传统的雪橇针带线图，B示传统脐部双穿刺孔，C、D示辅助钳辅助套线结扎过程。

Figure 1. Two different methods of umbilical puncture and schematic diagram of sledge needle with wire

下载: 全尺寸图片幻灯片

图 2 单孔脐部穿刺方法及雪橇针带线图

注：A示新的雪橇针带线方法，B示脐部单穿刺孔，C、D示单雪橇针套线结扎过程。

Figure 2. Single hole umbilical puncture method and sledge needle belt diagram

下载: 全尺寸图片幻灯片

表 1 2组患儿手术基本情况比较(x ±s)

Table 1. Comparison of the basic surgical conditions between the two groups of children(x ±s)

组别	例数	术中出血量(mL)	手术时间(min)	住院时间(d)	治疗费用(元)
对照组	104	1.28±0.53	14.17±3.53	4.51±1.50	7 271.65±93.09
观察组	116	1.29±0.56	13.83±3.14	4.05±1.39	6 798.94±469.19
t值		-0.193	0.768	2.350	8.678
P值		0.847	0.446	0.020	<0.001

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表 2 2组患儿围手术期不良反应指标比较(例)

Table 2. Comparison of perioperative adverse reactions indicators in the two groups(cases )

组别	例数	阴囊水肿	发热	切口愈合不良
对照组	104	1	3	9
观察组	116	1	2	2
χ²值			0.015	5.544
P值		1.000^a	0.902	0.019
注：^a为采用Fisher精确检验。对照组切口愈合不良包括：红肿1例、裂开2例、脐疝2例、线结反应4例；观察组：线结反应2例。

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