腹腔镜下小儿斜疝疝囊高位结扎术后复发高危因素分析

High Risk Factors of Recurrence after Laparoscopic High Ligation of Hernia Sac in Children with Indirect Hernia

目的:探究腹腔镜下小儿斜疝疝囊高位结扎术后复发高危因素,为临床上小儿斜疝的术后预防提供思路。方法:本研究为回顾性病例对照研究,以自2017年1月至2021年1月收入我院小儿外科的457例小儿腹股沟斜疝患儿为研究对象,根据是否复发,将入组的457例小儿腹股沟斜疝患儿分成两组:复发组10例,非复发组447例。统计并记录患儿的一般基准资料,比如性别,年龄,身高,体重和相关实验室指标,包括血沉,CRP等。利用单因素分析和Logistic回归多因素分析方法进行分析相关指标。结果:457例小儿腹股沟斜疝患儿采用腹腔镜下行小儿斜疝疝囊高位结扎后,复发10例,复发率为2.19%。单因素分析结果显示,年龄,BMI,ESR,CRP,内环口直径大小和结扎线类型是与腹腔镜下行小儿斜疝疝囊高位结扎术后复发的高危因素(P < 0.05)。多因素分析结果显示,ESR,CRP,内环口直径大小和结扎线类型是与腹腔镜下行小儿斜疝疝囊高位结扎术后复发的高危因素(P < 0.05)。结论:ESR,CRP,内环口直径大小和结扎线类型是与腹腔镜下行小儿斜疝疝囊高位结扎术后复发的高危因素,临床上要给予高度重视。

Objective: To explore the high risk factors of recurrence after laparoscopic high ligation of hernia sac in children with indirect hernia, and to provide ideas for clinical prevention of indirect hernia in children. Methods: This study was a retrospective case-control study. 457 children with indirect inguinal hernia who were admitted to the pediatric surgery department of our hospital from January 2017 to January 2021 were taken as the research objects. According to whether they relapsed, the 457 children with indirect inguinal hernia were divided into two groups: 10 in the recurrence group and 447 in the non recurrence group. Make statistics and record the general baseline data of the children, such as gender, age, height, weight and relevant laboratory indicators, including ESR, CRP, etc. Single factor analysis and logistic regression were used to analyze the related indicators. Results: After laparoscopic high ligation of indirect inguinal hernia sac in 457 children with indirect inguinal hernia, 10 cases recurred, and the recurrence rate was 2.19%. Univariate analysis showed that age, BMI, ESR, CRP, diameter of internal loop and type of ligation line were the high risk factors for recurrence after laparoscopic high ligation of indirect hernia sac in children (P < 0.05). The results of multivariate analysis showed that ESR, CRP, diameter of internal loop and type of ligation line were the high risk factors for recurrence after laparoscopic high ligation of indirect hernia sac in children (P < 0.05). Conclusion: The ESR, CRP, the diameter of inner ring and the type of ligation line are the high risk factors of recurrence after laparoscopic high ligation of indirect hernia sac in children, which should be paid more attention in clinic.