胸腔镜下疝针治疗先天性膈疝效果观察

Effect of Thoracoscopic Combined With Hernia Needle in the Treatment of Congenital Diaphragmatic Hernia

目的观察胸腔镜下疝针治疗先天性膈疝的效果。方法选取2018年1月—2020年10月玉林市妇幼保健院小儿外科收治的40例先天性膈疝患儿,采用随机数字表法分组,对照组(20例,予传统三孔胸腔镜修补)、观察组(20例,予胸腔镜下联合疝针修补),比较两组治愈率、手术时间、术后撤机时间、住院时间、术中出血量、复发率及并发症的发生率。结果两组患儿均顺利完成手术,观察组治愈率为90.00%(18/20),对照组则为75.00%(15/20),观察组治愈率显著高于对照组,差异有统计学意义(P<0.05),观察组手术时间为(86.24±8.33)min、术后撤机时间为(7.81±2.25)d、术中出血量为(5.51±1.22)mL、住院天数为(20.21±5.72)d,低于对照组的(97.62±9.12)min、(9.66±2.36)d、(8.56±2.33)mL、(25.60±7.21)d,差异有统计学意义(P<0.05)。两组复发率比较,差异无统计学意义(P>0.05);两组并发症发生率比较,差异有统计学意义(P<0.05)。结论先天性膈疝患儿在接受手术治疗时,采用胸腔镜下疝针的方法不仅能取得良好的手术效果,还能减轻术中损伤,增强安全性,加快康复速度,是先天性膈疝治疗理想的修补术式。

Objective To observe the effect of thoracoscopic hernia needle in the treatment of congenital diaphragmatic hernia.Methods From January 2018 to October 2020,40 children with congenital diaphragmatic hernia who were admitted to the Department of Pediatrics of Yulin Maternal and Child Health Hospital were selected.By random number table method,they were divided into control group(20 cases,repaired by traditional three-hole thoracoscopy)and observation group(20 cases,repaired by thoracoscopic combined hernia needle),the cure rate,operation time,postoperative weaning time,hospital stay,intraoperative blood loss,recurrence rate and incidence of complications were compared between the two groups.Results Both groups of children completed the operation successfully,the cure rate of the observation group was 90.00%(18/20),and that of the control group was 75.00%(15/20),the cure rate of the observation group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).The operation time of the observation group was(86.24±8.33)min,the postoperative weaning time was(7.81±2.25)d,the intraoperative blood loss was(5.51±1.22)mL,and the length of hospital stay was(20.21±5.72)d,which were lower than(97.62±9.12)min,(9.66±2.36)d,(8.56±2.33)mL,(25.60±7.21)d of the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the recurrence rate between the two groups(P>0.05);there was a statistically significant difference in the incidence of complications between the two groups(P<0.05).Conclusion When children with congenital diaphragmatic hernia receive surgical treatment,the method of thoracoscope combined with hernia needle can not only achieve good surgical results,but also reduce intraoperative injury,enhance safety,and speed up recovery.It is the treatment of congenital diaphragmatic hernia.The most ideal repair surgery.