两种手术方式治疗小儿嵌顿性腹股沟斜疝的临床疗效

目的 比较腹腔镜与传统开放疝囊高位结扎术治疗小儿嵌顿性腹股沟斜疝的疗效.方法 收集2010年1月至2016年1月小儿嵌顿性腹股沟斜疝患者260例,随机分为腹腔镜组和开放组,每组各130例.腹腔镜组行腹腔镜下疝囊高位结扎术,开放组行开放疝囊高位结扎术,观测并比较两组患者围手术期相关指标、术后并发症发生率及复发率.结果 腹腔镜组患者切口长度、术中出血量、手术时间、C反应蛋白(CRP)水平、通气时间、下地活动时间以及住院时间明显优于开放组(P<0.05).腹腔镜组术后并发症发生率明显少于开放组(P<0.05),两组患者术后复发率比较,差异无统计学意义(P>0.05).结论? 两种手术方式治疗小儿嵌顿性腹股沟斜疝均能够取得良好的临床疗效,但腹腔镜下治疗小儿嵌顿性腹股沟斜疝患儿具有创伤小、康复快的优势,并可同时处理对侧病变,且安全性较好,值得在临床进一步推广应用.

Objective To compare the clinical efficacy of laparoscopic and open hernial sac high ligation treatment for pediatric incarcerated oblique inguinal hernia.Methods The patients with pediatric incarcerated oblique inguinal hernia(260 cases)treated in our hospital from July 2011 to January 2016 were randomly divided into laparoscopy group and open group,130 cases in each group.The laparoscopy group was given laparoscopic hernial sac high ligation,open group was given open hernial sac high ligation.The perioperative indicators,postoperative complications and recurrence rate were observed and compared between the two groups.Results The operation time,length of incision,blood loss and C-reactive protein(CRP)level in the laparoscopy group were better than those of the open group,there were statistically significant differences between the two groups(P<0.05).The postoperative anal exhaust time,group activity time and the average hospitalization time in laparoscopy group were significantly less than those of the open group(P<0.05).Postoperative complications significantly decreased in the laparoscopic group(P<0.05),while there were no significant differences in the recurrence rate between the two groups(P>0.05).Conclusion Two surgical methods treatment for pediatric incarcerated oblique inguinal hernia could achieve good clinical efficacy,laparoscopic treatment for pediatric incarcerated oblique inguinal hernia has the advantage of less trauma,faster postoperative recovery and deal with the contralateral lesion at the same time,without increasing the incidence of postoperative complications,which is valuable to be applied in clinical.