门诊手术模式治疗小儿腹股沟斜疝4520例临床研究

The Clinical Research on 4520 Cases with Pediatric Indirect Inguinal Hernia Repaired Throngh Out-patient Surgical Model

目的介绍具有我国特色的小儿腹股沟斜疝门诊手术模式,探讨手术相关问题。方法回顾分析4520例小儿腹股沟斜疝门诊手术记录,并对患儿进行电话形式的随访调查,对这一具有我国特色门诊手术模式的经验进行总结。结果本组4520例手术病人无死亡,无手术部位错误,无病人投诉,无严重并发症或后遗症发生,其中有6例(1.32‰)术后收住入院观察,其余患儿均手术当日离院回家。术中发现腹股沟滑疝13例(2.87‰),行疝囊成形加疝囊高位结扎术;术后腹股沟斜疝复发14例(3.1‰);术后手术对侧发生斜疝123例(2.9%)。结论在有丰富临床经验的小儿外科及小儿麻醉医师手中,门诊腹股沟斜疝手术十分安全;规范合理的门诊治疗模式对减少并发症与病人投诉、更好地提高治疗效果相当重要。

To introduce out - patient surgical model of pediatric indirect inguinal hernia with chinese characteristics and discuss the related problems to operation. Methods Retrospective study of 4520 cases with pediatric inguinal hernia in out - patient sur- gery and a telephone survey to assess any long - term morbidity related to the operation were done, then experiences of this surgical model which related to the indirect inguinal hernia repair were sumed up. Results In 4520 cases, there was no death, no wrong of operative lo- cation, no complaint to the surgeons, no severe morbidity developed. Six patients（1.32‰） were unplanned admitted to hospital for obser- vation, and others promptly went home on the operative day. Thirteen patients（2.87‰） were carried out with hernia ligation and hernia sac shaping up for sliding hernia. Fourteen patients（3.1‰） had developed hernia recurrence and 123 cases（2.9% ）of contra -lateral in- guinal hernias occcurred. Conclusion If indirect inguinal hernia repair in the out - patient surgery was handled by the skilled pediatric surgeons and anesthetists, it would be very safe. To decrease operative complications and complaint of the patient, enchance treatment effect of the operation, it is very significant to standardize the out - patient surgical model of pediatric indirect inguinal hernia repair.