超微单孔腹腔镜治疗小儿鞘状突未闭的疗效及对血清WBC、CRP水平的影响

Curative effect of ultramicro single-port laparoscopy on patent processus vaginalis and the influence on serum WBC and CRP level

目的:分析超微单孔腹腔镜治疗小儿鞘状突未闭的疗效及对血清白细胞计数(WBC)、C反应蛋白(CRP)水平的影响。方法:选择2019年01月~2020年11月于我院接受治疗的120例小儿鞘状突未闭患儿为研究对象,根据手术通道数目分为传统脐三孔组、双孔组和单孔组,比较三组手术相关指标、术后疼痛情况、手术切口美观评分、术后复发情况、炎症因子水平及并发症发生情况。结果:单孔组手术时间、术后住院时间、手术出血量显著优于传统脐三孔组和双孔组,单孔组术后24 h、48h视觉模拟评分量表(VAS)评分显著低于双孔组和传统脐三孔组,单孔组温哥华瘢痕评价量表(VSS)评分、患者瘢痕自我评分(PSAS)显著低于双孔组和传统脐三孔组,单孔组并发症总发生率显著低于双孔组和传统脐三孔组,单孔组、双孔组及传统脐三孔组WBC和CRP水平及术后复发率比较无统计学意义。结论:超微单孔腹腔镜治疗小儿鞘状突未闭效果较好,可有效缩短术后住院时间、手术时间、降低术中出血量,患儿疼痛感较低,手术切口美观度高,并发症发生率低,值得在临床治疗中进一步推广。

Objective To analyze the curative effect of ultramicro single-port laparoscopy on patent processus vaginalis and the influence onserum white blood cell count(WBC)and C-reactive protein CRP level.Methods A total of 120 childrenwith patent processus vaginalis treated in the hospital from January 2019 to November 2020 were enrolled as the research objects.According to the number of surgical channels,they were divided into traditional umbilical three-port group,double-port group and single-port group.The surgery-related indexes,postoperative pain,aesthetic score of surgical incision,postoperative recurrence,levels of inflammatory factors and complications were compared among the three groups.Results The operation time,postoperative hospitalization time and blood loss in single-port group were significantly better than those in traditional umbilical three-port group and double-port group.The visual analogue scale(VAS)scores at 24 h and 48 h after surgery were significantly lower than those in double-hole group and traditional umbilical three-hole group.The Vancouver Scar Assessment(VSS)and patient’s scar assessment(PSAS)scores were significantly lower than those in double-hole group and traditional umbilical three-hole group,and the total incidence of complications was significantly lower than that in double-hole group and traditional umbilical three-hole group.There were no statistically significant differences in WBC,CRP and the incidence of complications among the three groups.Conclusion Ultramicro single-port laparoscopy is effective in the treatment of patent processus vaginalis in children.It can effectively shorten postoperative hospitalization time and operation time,and reduce intraoperative blood loss,with mild pain,high aesthetics of surgical incision,and a low incidence of complications.