小儿腹股沟斜疝疝囊高位结扎术对睾丸发育的影响

Effect of high ligation of hernia sac on testis in infants with indirect inguinal hernia

目的比较小儿腹股沟斜疝的手术及非手术疗效,观察小儿腹股沟疝术后对睾丸发育的影响。方法经临床及超声检查诊断为腹股沟斜疝患儿300例,其中150例患儿行腹股沟斜疝疝囊高位结扎术;另150例患儿保守治疗(补中益气丸加敦煌272脐密带),12例治疗无效后转手术治疗,其中5例发生嵌顿而行急诊手术。所有患儿治疗后6个月随访。治疗前后对比2组患侧睾丸的位置、大小、睾丸动脉收缩期最大流速。结果手术组术后复发5例,非手术组术后复发8例。小儿腹股沟斜疝的手术及非手术治疗疗效差异无统计学意义(P>0.05)。但是疝囊高位结扎术与非手术治疗比较,术后6个月前者对患儿的睾丸体积、血流影响较大(P<0.05)。结论小儿腹股沟斜疝手术与非手术治疗的疗效差异虽然无统计学意义,但前者对患儿睾丸体积和血流量影响较大。

Objective To compare the effects of surgery and non-surgical treating on indirect inguinal hernia and observe operational effect on the testis. Methods A total of 300 infants were diagnosed as indirect inguinal hernia by clinical and ultrasound examinations. Totally 150 patients received the high ligation of hernia sac and 150 cases received conservative treatment （buzhongyiqiwan and 272 qimidai）. Among the latter, 12 eases received surgical treatment after conservative treatment was ineffective, including emergency surgery was performed in 5 cases who occurred incarceration. All the infants were followed up 6 months after the treatment, comparing the location, size, and testicular artery peak systolic velocity of testis before and after the treatment between the two groups. Results Five patients recrudesced in the operation group, and 8 cases recrudesced in the non-operation group. The effect of high ligation of hernia sac on testicular volume and blood flow was bigger than that of non-surgical treatment after 6 month. Conclusions The effects of surgery and non-surgical treatment were not significantly different in the infants with inguinal hernia. However, the effect of the former on testicular volume and blood flow is bigger than that of the latter.