比较腹腔镜手术与小切口手术治疗小儿鞘膜积液的临床治疗安全性

Comparison on the Clinical Safety of Laparoscopic Surgery and Small Incision Surgery in the Treatment of Hydrocele in Children

目的 评价小儿鞘膜积液应用腹腔镜手术与小切口手术治疗的效果与安全性。方法 选择该院2019年1月—2021年6月期间接诊的96例鞘膜积液患儿,根据随机数表法进行分组,对照组与观察组均为48例,对照组接受小切口手术治疗,观察组接受腹腔镜手术治疗,将两组鞘膜积液患儿的手术时间、住院天数、住院费用、术中出血量、疾病复发率、切口感染率、术后阴囊肿胀率、收缩峰值血流速度(PSV)、舒张末期血流速度(EDV)、睾丸动脉阻力指数(RI)进行对比。结果观察组手术时间(18.31±4.25)min、住院天数(2.62±1.36)d短于对照组,住院费用(6 355.65±352.69)元高于对照组,术中出血量(3.44±0.58)mL小于对照组,差异有统计学意义(t=12.440、7.291、13.457、18.301,P<0.05)。两组切口感染率、疾病复发率比较,差异无统计学意义(P>0.05)。但观察组术后阴囊肿胀率(2.08%)低于对照组(16.67%),差异有统计学意义(P<0.05)。观察组术后3个月的PSV、EDV、RI均大于对照组,差异有统计学意义(P<0.05)。结论 腹腔镜手术治疗的手术时间更短,术中出血量更少,还可以降低患儿术后阴囊肿胀率,值得在临床中予以推广使用。

Objective To evaluate the efficacy and safety of laparoscopic surgery and small incision surgery for hydrocele in children. Methods A total of 96 children with hydrocele who were admitted to the hospital from January 2019 to June 2021 were selected and grouped according to the random number table method. There were 48 cases in both the control group and the observation group. The control group received small incision surgery. The observation group received laparoscopic surgery. The operative time, hospitalization days, hospitalization costs, intraoperative blood loss, disease recurrence rate, incision infection rate, postoperative scrotal swelling rate, peak systolic blood flow velocity(PSV), end diastolic blood flow velocity(EDV) and testiculovr arterial resistance index(RI) were compared between the two groups of children with hydrothecal effusion. Results The operation time of the observation group was(18.31±4.25)min, the length of hospital stay(2.62±1.36)d was shorter than that of the control group, the hospitalization cost was(6 355.65±352.69)yuan higher than that of the control group, and the intraoperative blood loss was(3.44±0.58)mL less than that of the control group, the difference was statistically significant(t=12.440,7.291, 13.457, 18.301, P <0.05). There was no statistically significant difference in incision infection rate and disease recurrence rate between the two groups(P>0.05). However, the postoperative scrotal swelling rate(2.08%) in the observation group was lower than(16.67%) that in the control group, and the difference was statistically significant(P<0.05). The PSV, EDV and RI of the observation group were higher than those of the control group at 3 months after operation, and the difference was statistically significant(P<0.05). Conclusion Laparoscopic surgery has a shorter operation time, less intraoperative blood loss, and can also reduce the postoperative scrotal swelling rate in children after surgery, which is worthy of promotion in clinical practice.