腹腔镜疝囊高位结扎联合脐正中襞覆盖修补对小儿单侧腹股沟斜疝术后复发的影响

Application of Laparoscopic High Ligation of Hernia Sac Combined with Median Umbilical Fold in Treatment of Unilateral Inguinal Hernia in Children

【目的】探讨腹腔镜疝囊高位结扎联合脐正中襞覆盖修补对小儿单侧腹股沟斜疝术后复发的影响。【方法】回顾性分析2015年7月至2018年3月241例在平顶山学院,第一附属医院接受治疗的单侧腹股沟斜疝患儿的临床资料,根据治疗方式的不同分为对照组(n=96)和观察组(n=145),分别行腹腔镜疝囊高位结扎术及腹腔镜疝囊高位结扎术联合脐正中襞覆盖修补。比较两组围手术期情况、术后并发症,以及术后1年的复发情况。【结果】两组的手术时间、住院时间和术后24 h疼痛评分比较,差异均无统计学意义(P>0.05)。两组患儿术后均未出现阴囊水肿、医源性隐睾、腹腔感染等并发症。两组患儿术后切口感染、鞘膜积液、腹股沟区疼痛发生率比较,差异无统计学意义(χ^(2)=0.245,P=0.625>0.05)。术后1年,观察组无复发病例,对照组3例(3.13%)复发,两组比较差异有统计学意义(P<0.05)。【结论】腹腔镜疝囊高位结扎联合脐正中襞覆盖修补的疗效确切,能够明显减少术后复发率。

【Objective】To investigate the application of laparoscopic high ligation of hernia sac and median umbilical fold in treatment of unilateral inguinal hernia in children.【Methods】The clinical data of 241 children with unilateral inguinal hernia treated in our hospital from July 2015 to March 2018 were collected.According to different treatment methods,all of the children were divided into the control group(n=96)and the observation group(n=145).Laparoscopic high ligation o£hernia sac and laparoscopic high ligation of hernia sac combined with median umbilical fold were performed respectively.The perioperative period,postoperative complications and recurrence after 1 years of the two groups were compared.【Results】The operative time,hospitalization time and pain score at 24 h of the two groups had no significant difference(P>0.05).There was no significant difference between the two groups in incision infection,hydrocele and groin pain(P>0.05).One year follow up after operation showed that there was no recurrence in the observation group,however,there were 3 cases(3.13%)in the control group..The difference between the two groups was statistically significant(F<0.05).【Conclusion】Laparoscopic high ligation of hernia sac combined with median umbilical fold in treatment o£unilateral inguinal hernia is effective.It can significantly reduce postoperative recurrence rate.