腹腔镜疝囊高位结扎术中缝合法与疝针法的效果分析

The effective analysis of laparoscopic suture method and hernia needle method in laparoscopic high ligation of hernia sac

目的:对比分析腹腔镜疝囊高位结扎术中采用缝合法与疝针法的临床疗效。方法:选取2008年1月至2013年9月收治的90例腹股沟斜疝患儿作为研究对象,患儿均行腹腔镜疝囊高位结扎术,随机分为两组,术中分别采用缝合法(缝合组)与疝针法(疝针组)结扎疝囊,每组45例。对比分析两组患儿的临床疗效及并发症情况。结果:两组临床疗效及术后并发症发生率差异均无统计学意义(P>0.05)。术后随访半年,缝合组中复发1例,发生阴囊气肿2例、鞘膜积液2例、皮下血肿2例,共发生并发症7例;疝针组发生鞘膜积液、阴囊气肿各1例,无复发、皮下血肿发生,共发生并发症2例;两组相比差异无统计学意义(P>0.05)。结论:腹腔镜疝囊高位结扎术中采用缝合法与疝针法治疗小儿腹股沟斜疝均是安全、有效的,具有手术时间短、术后康复快、住院时间短、并发症少等优点,疝针法操作更为简便,且容易掌握;术者可根据自身技术水平选择适当的术式。

Objective ： To compare and analyze the clinical effect of suture method and hernia-needle method during the laparo-scopic high ligation Of hernia sac in the treatment of inguinal hernia. Methods：The clinical data of 90 children with indirect inguinal hernia from Jan. 2008 to Sep. 2013 were analyzed retrospectively. They were divided into 2 groups randomly：laparoscopic suture group and hernia-needle group, including 45 patients in each group. All patients received the laparoscopic high ligation of hernia sac by suture or hernia-needle method. The differences between two groups in the clinical effect and the incidence of complications were compared be-tween 2 groups. Results：There were no significant differences in clinical effect and incidence of postoperative complications between two groups （ P 〉 0.05 ）. The patients were followed up for 6 months. The suture group had 7 cases with complications ： 1 case of recurrence, 2 cases of scrotum emphysema,2 cases of hydrocele of tunica vaginalis,2 cases of ecchymoma. Hernia-needle group had no recurrence and no ecchymoma, 1 case of hydrocele of tunica vaginalis, 1 case of scrotum emphysema. All the differences were not statistically signif-icant （ P 〉 0.05 ）. Conclusions ： Suture method and hernia-needle method during the laparoscopic high ligation of hernia sac in the treatment of indirect inguinal hernia are safe and effective for children, and has advantages of shorter operation time, quicker recovery, shorter hospital stay and fewer complications. Compared to the suture method, hernia-needle method is simpler and easier to master. Sur-geons should choose appropriate method according to their technical levels.