腹腔镜疝囊高位结扎术治疗小儿腹股沟疝对WBC、CRP水平及1年复发率的影响

Effects of laparoscopic high ligation of the hernial sac on WBC,CRP levels and the 1⁃year recurrence rate in children with inguinal hernia

目的 探究腹腔镜疝囊高位结扎术治疗小儿腹股沟疝对白细胞计数(WBC)、C反应蛋白(CRP)水平及1年复发率的影响。方法 选择2017年1月至2022年1月来金寨县中医医院就诊的腹股沟疝患儿60例,根据手术方式的不同,分为腹腔镜组(n=30)和传统组(n=30),传统组采用传统开放式疝囊高位结扎术,腹腔镜组采用腹腔镜疝囊高位结扎术。比较两组患儿围手术期指标,术前及术后12 h的应激指标WBC及CRP水平,术后6、12、24 h的疼痛(VAS)评分。随访1年,观察复发情况及并发症发生情况。结果 腹腔镜组的手术时间、下床活动时间、住院时间均短于传统组(t=13.519、14.434、6.280,P<0.05),术中出血量低于传统组(t=13.351,P<0.05);术后,两组患儿的WBC及CRP水平均升高,较术前差异有统计学意义(P<0.05),但腹腔镜组低于传统组,差异有统计学意义(t=5.984、6.562,P<0.05);术后6、12、24 h,腹腔镜组的VAS评分均低于传统组(t=4.111、4.989、4.864,P<0.05);随访1年,腹腔镜组和传统组的复发率分别为0.00%、3.33%,两组比较差异无统计学意义(χ^(2)=1.017,P>0.05);术后,腹腔镜组的并发症发生率为3.33%,低于传统组的30.00%(χ^(2)=7.680,P<0.05)。结论 腹腔镜疝囊高位结扎术治疗小儿腹股沟疝创伤小,能有效改善炎症反应水平,术后疼痛轻、并发症少,有利于患儿术后恢复,且复发率较低。

Objective To explore the effects of laparoscopic high ligation of the hernial sac on white blood cell count(WBC),C⁃reactive protein(CRP)levels and the 1⁃year recurrence rate in children with inguinal hernia.Methods A total of 60 children with inguinal hernias were treated at Jinzhai County Hospital of Traditional Chinese Medicine between January 2017 and January 2022.They were divided into two groups based on the surgical method used:laparoscopic group(n=30)and traditional group(n=30).The traditional group underwent traditional open high ligation of the hernial sac,while the laparoscopic group received laparo⁃scopic high ligation of the hernial sac.Perioperative indexes,levels of stress markers(WBC,CRP)before and 12 hours after surgery,and Visual Analogue Scale(VAS)scores at 6,12 and 24 hours post⁃surgery were com⁃pared between the two groups.Recurrence and complications were observed during a one⁃year follow⁃up period.Results The operation time,leaving bedtime and hospitalization time in the laparoscopic group were shorter than those in the traditional group(t=13.519,14.434,6.280,P<0.05).Additionally,intraoperative blood loss was lower in the laparoscopic group compared to the traditional group(t=13.351,P<0.05).After surgery,levels of WBC and CRP increased in both groups,with a statistically significant difference compared to pre⁃surgery levels(P<0.05).The levels of WBC and CRP in the laparoscopic group were lower than those in the traditional group,and the difference was statistically significant(t=5.984,6.562,P<0.05).At 6,12 and 24 hours post⁃sur⁃gery,VAS scores in the laparoscopic group were lower than those in the traditional group(t=4.111,4.989,4.864,P<0.05).After a 1⁃year of follow⁃up,there was no significant difference in recurrence rates between the laparo⁃scopic group and the traditional group(0.00%vs 3.33%,χ^(2)=1.017,P>0.05).After surgery,the incidence of com⁃plications in laparoscopic group was lower than that in traditional group(3.33%vs 30.00%,c2=7.680,P<0.05).Conclusion The laparoscopic high ligation of the hernial sac is a minimally traumatic treatment for children with inguinal hernias.This procedure effectively reduces inflammatory response,resulting in mild postoperative pain and fewer complications.It also promotes quicker postoperative recovery for children,with a low recurrence rate.