微型腹腔镜小儿腹股沟疝高位结扎术的临床应用研究

Clinical Study of Mini-laparoscopic High Ligation on Inguinal Hernia in Children

目的探究微型腹腔镜小儿腹股沟疝高位结扎术的临床应用价值。方法将2016年9月-2017年10月入院的70例小儿腹股沟疝患儿采用随机数表法分为研究组和对照组,每组35例。对照组采用传统术式,研究组采用微型腹腔镜下疝囊高位结扎术。观察2组术中、术后一般情况,评估患儿疼痛状况(疼痛时间、术后6h疼痛强度[东大略儿童医院疼痛评分(CHEOPS)]),记录患儿并发症发生率及6个月复发率。结果 (1)研究组手术时间、切口长度、出血量、住院时间、术后卧床时间均小于对照组(P<0.05);(2)研究组疼痛时间、术后6h CHEOPS评分均小于对照组(P<0.05);(3)研究组术后发热率、6个月复发率均低于对照组(P<0.05),两组鞘膜积液、阴囊/大阴唇肿胀发生率对比差异无统计学意义(P>0.05)。结论微型腹腔镜小儿腹股沟疝高位结扎术能显著改善患儿术中、术后一般情况及疼痛状况,在提供患儿治疗体验的同时降低术后发热率及复发率,临床应用价值可观。

Objective To explore the clinical value of mini-laparoscopic high ligation on inguinal hernia in children. Methods 70 children with inguinal hernia treated in hospital from Sep. 2016 to Oct. 2017 were randomly divided into study group （35 cases） and control group （35 cases）. The control group was treated with conventional operation, while the study group was treated with mini-laparoscopic high ligation of hernial sac. The intraoperative and postoperative general situations in the two groups were observed, the pain conditions in the two groups were evaluated （pain time, pain intensity 6h after operation [Children’s Hospital EasternOntario Pain Scale,（CHEOPS）]）, and the incidence rates of complications and recurrence rates 6 months after operation in the two groups were recorded. Results The operation time, incision length, blood loss, hospitalization time and postoperative bed time in the study group were all less than those in the control group （P〈0.05）, the pain time and CHEOPS score 6h after operation in the study group were all less than those in the control group （P〈0.05）, the postoperative fever rate and recurrence rate 6 months after operation in the study group were all lower than those in the control group （P〈0.05）, there was no signifcant difference in hydrocele and incidence of scrotum / labium majus swelling between the two groups （P〉0.05）. Conclusion Mini-laparoscopic high ligation which has considerable value, can not only signifcantly improve the intraoperative and postoperative general situation and pain condition of children with inguinal hernia, but also reduce the postoperative fever and recurrence rates while providing treatment experience for children.