单孔腹腔镜改良单凹槽单疝气针手术治疗小儿腹股沟斜疝的疗效研究

Single-port laparoscopic modified single-groove single hernia needle surgery for indirect inguinal hernia in children

目的:探讨单孔腹腔镜改良单凹槽单疝气针手术治疗小儿腹股沟斜疝的疗效。方法:选取2017年1月~2018年12月于本院就诊的100例腹股沟斜疝患儿为研究对象,根据随机数表法分成观察组(50例)与对照组(50例)。观察组行单孔腹腔镜改良单凹槽单疝气针手术治疗,对照组行传统雪橇疝气钩针手术治疗。观察两组患者术中指标、术后疼痛、下床时间、住院时间、并发症率、斜疝复发率以及对侧疝发生率。结果:观察组手术时间、总切口长度与对照组比较,差异无统计学意义;观察组出血量、术中腹膜破损(15.19±4.63mL、2.00%)少于对照组(17.07±4.21mL、14.00%),观察组两次穿刺同一隧道率(100.00%)明显高于对照组(62.00%),差异有统计学意义。观察组术后疼痛评分(2.06±0.62分)显著低于对照组(2.47±0.59分),差异有统计学意义;观察组下床时间和住院时间与对照组比较,差异无统计学意义。观察组并发症率(4.00%)显著低于对照组(16.00%),差异有统计学意义。观察组斜疝复发率及对侧疝发生率(0.00%、2.00%)均显著低于对照组(10.00%、14.00%),差异有统计学意义。结论:单孔腹腔镜改良单凹槽单疝气针手术治疗小儿腹股沟斜疝可减少患者术中出血,减轻术后疼痛,降低并发症、斜疝复发以及对侧疝发生风险,具有较高的临床推广应用价值。

Objective To investigate the effect of modified single-groove single hernia needle operation with single-hole laparoscopy in the treatment of indirect inguinal hernia in children.Methods A prospective study was conducted on 100 children with indirect inguinal hernia treated in our hospital from January 2017 to December 2018.They were divided into observation group(50 cases)and control group(50 cases)according to random number table.The observation group was treated with single-hole laparoscopic modified single-groove single hernia needle operation,while the control group was treated with traditional sled hernia hook needle operation.The operative indexes,postoperative pain,time out of bed,hospital stay,complication rate,recurrence rate of indirect hernia and incidence of contralateral hernia were observed.Results There was no significant difference in operation time and total incision length between the observation group and the control group.The amount of bleeding and peritoneal damage in the observation group(15.19+4.63 mL,2.00%)were less than those in the control group(17.07+4.21 mL,14.00%).The same tunnel puncture rate in the observation group(100.00%)was significantly higher than that in the control group(62.00%).The difference was statistically significant.The pain score of the observation group(2.06±0.62 points)was significantly lower than that of the control group(2.47+0.59 points),and the difference was statistically significant.There was no significant difference in the time of getting out of bed and hospitalization between the observation group and the control group.The complication rate of the observation group(4.00%)was significantly lower than that of the control group(16.00%),and the difference was statistically significant.The recurrence rate of oblique hernia and the incidence of contralateral hernia in the observation group(0.00%and 2.00%)were significantly lower than those in the control group(10.00%and 14.00%),and the difference was statistically significant.Conclusion Single-port laparoscopic modified single-groove single hernia needle surgery for indirect inguinal hernia in children can reduce the bleeding,pain,complications,recurrence of indirect hernia and the risk of contralateral hernia.It has a high clinical application value.