腹腔镜疝气修补结合注水分离腹膜法在小儿疝气中的临床效果

Clinical Effect of Laparoscopic Hernia Repair Combined with Water Injection for Peritoneal Separation in Children with Hernia

目的探讨在小儿疝气中应用腹腔镜疝气修补结合注水分离腹膜法治疗的效果。方法方便选取2022年1月—2023年6月民勤县人民医院收治的76例小儿疝气患儿为研究对象,按不同治疗方法分成观察组(n=38)和对照组(n=38)。对照组给予传统疝修补术,观察组采取腹腔镜疝气修补结合注水分离腹膜法。比较两组患儿的术中失血量、单侧或双侧手术时间、术后初次下床活动时间及住院天数,术后1 d、7 d的白细胞介素-6(interleukin-6,IL-6)、C反应蛋白(C-reactive protein,CRP)水平,以及两组并发症发生率和复发率。结果观察组患儿的术中失血量少于对照组,单侧或双侧手术时间、术后初次下床活动时间及住院天数均短于对照组,差异有统计学意义(P均<0.05)。两组患儿术后1 d的IL-6水平明显升高,且观察组低于对照组,差异有统计学意义(P均<0.05)。两组术后7 d的IL-6、CRP水平均明显降低,且观察组低于对照组,差异有统计学意义(P均<0.05)。观察组的并发症发生率[2.63%(8/38)]低于对照组[21.05%(1/38)],差异有统计学意义(χ^(2)=6.176,P<0.05)。两组患儿复发率比较,差异无统计学意义(P>0.05)。结论疝气患儿通过腹腔镜疝气修补结合注水分离腹膜法治疗,有利于改善手术相关指标,降低患儿术后疼痛程度、并发症发生率,且有效减少感染发生,有利于后期机体恢复。

Objective To investigate the effect of laparoscopic hernia repair combined with water injection for peritoneal separation in children with hernia.Methods A total of 76 children with hernia admitted to Minqin County People's Hospital from January 2022 to June 2023 were conveniently selected as the study objects,and divided into observation group(n=38)and control group(n=38)according to different treatment methods.The control group received traditional hernia repair,and the observation group received laparoscopic hernia repair combined with water injection to separate the peritoneum.The intraoperative blood loss,unilateral or bilateral operation time,first time of getting out of bed after operation and number of days in hospital of the two groups were compared,and the levels of interleukin-6(IL-6)and C-reactive protein(CRP)on day 1 and day 7 after surgery were compared.And complication rates and vecurrence rate were compared between two groups.Results The intraoperative blood loss in the observation group was less than that in the control group,and the time of unilateral or bilateral operation,the first time of getting out of bed after operation and the days of hospitalization were shorter than that in the control group,the differences were statistically significant(all P<0.05).The levels of IL-6 in 2 groups were significantly increased 1 day after surgery,and the observation group was lower than the control group,the differences were statistically significant(both P<0.05).The levels of IL-6 and CRP in both groups were significantly decreased 7 days after surgery,and the observation group was lower than the control group,the differences were statistically significant(both P<0.05).The complication rate of observation group[2.63%(8/38)]was lower than that of control group[21.05%(1/38)],and the difference was statistically significant(χ^(2)=6.176,P<0.05).There was no significant difference in the recurrence rate between the two groups(P>0.05).Conclusion Laparoscopic hernia repair combined with water injection to separate the peritoneum in children with hernia is beneficial to improve the relevant indexes of surgery,reduce the degree of postoperative pain and the incidence of complications,and effectively reduce the incidence of infection,which is conducive to the recovery of the body in the later stage.