BACKGROUND Inguinal hernia is a common clinical manifestation in children with a low selfhealing rate.AIM To determine the effect of laparoscopic surgery on indirect inguinal hernia and the risk factors for postoperat...BACKGROUND Inguinal hernia is a common clinical manifestation in children with a low selfhealing rate.AIM To determine the effect of laparoscopic surgery on indirect inguinal hernia and the risk factors for postoperative recurrence and to provide a reference for the clinical treatment and prevention of recurrence.METHODS We selected 360 children who underwent laparoscopic high ligation in our hospital as the laparoscopic group and 120 patients treated for inguinal hernia with conventional surgery as the control group.The operation time,blood loss,incision length,hospitalization time,total hospitalization cost and surgical complications were compared between the two groups.According to telephone follow-up or return visits,the children who had recurrence within 2 years after the operation in the laparoscopic group were analyzed,and the laparoscopic high ligation hernia sac level was analyzed by the logistic multifactor method.Ligation was used to treat recurrence in children with inguinal hernia.RESULTS The operation time,blood loss,length of incision,and length of hospital stay in the laparoscopic group were lower than those in the control group(P<0.05).The total hospitalization cost in the laparoscopic group was higher than that in the control group(P<0.05).The operative complication rate was 1.67%lower than that in the control group(12.50%)(P<0.05).In 360 children with laparoscopic high ligation of the hernia sac,14 patients had recurrence within 2 years after surgery.After analysis,14 cases in the recurrence group did not recur.The preoperative incarceration rate,inner ring diameter,ligature use and age difference were statistically significant(P<0.05).According to logistic regression multivariate analysis,an inner ring diameter≥1.0 cm,the use of an absorbable ligature line and age>3 years increased the risk of postoperative recurrence in children with inguinal hernia after laparoscopic high ligation of the hernia sac(P<0.05).CONCLUSION Laparoscopic surgery for indirect inguinal hernia in children has the advantages of low trauma and a rapid postoperative recovery.An inner ring diameter≥1.0 cm,the use of absorbable ligature,and age>3 years may increase the risk of recurrence after laparoscopic high ligation of the hernia sac.展开更多
目的探讨右美托咪定联合动画片干预对防治全麻腹腔镜疝囊高位结扎术患儿术后行为改变的临床意义。方法选取2020年4月—2022年12月择期行全麻腹腔镜疝囊高位结扎术的患儿270例为研究对象,根据就诊序号采用电脑随机数字表法分为A组(予以...目的探讨右美托咪定联合动画片干预对防治全麻腹腔镜疝囊高位结扎术患儿术后行为改变的临床意义。方法选取2020年4月—2022年12月择期行全麻腹腔镜疝囊高位结扎术的患儿270例为研究对象,根据就诊序号采用电脑随机数字表法分为A组(予以右美托咪定干预)、B组(予以动画片干预)、C组(予以右美托咪定联合动画片干预),每组90例。比较3组不同时间点平均动脉压(MAP)、心率(HR)、呼气末二氧化碳分压(P ET CO_(2))、血氧饱和度(SpO_(2))、呼吸频率(RR)、改良耶鲁围术期焦虑量表(mYPAS)评分以及诱导期合作度量表(ICC)评分、苏醒期躁动评分量表(PAED)评分、躁动发生率、苏醒情况、术后行为改变情况。结果在术前麻醉准备期间(T 2)、入手术室(T3)、术后苏醒即刻(T4),C组HR、MAP低于A组、B组(P<0.05)。3组P_(ET)CO_(2)、SpO_(2)、RR在组间、时间及组间·时间交互作用比较差异均无统计学意义(P>0.05)。T2、T3时,C组mYPAS评分低于A组、B组(P<0.05)。C组ICC、PAED评分及苏醒期躁动率低于A组、B组(P<0.05)。术后1、7 d,C组行为改变发生率低于A组、B组(P<0.05)。3组拔管时间、意识恢复时间、麻醉恢复室停留时间及不良事件总发生率比较差异无统计学意义(P>0.05)。结论右美托咪定联合动画片干预可降低行全麻腹腔镜疝囊高位结扎术患儿术前焦虑,提升患儿麻醉诱导合作程度,降低苏醒期躁动及术后行为改变发生率,且对患儿血流动力学影响较小,安全性高。展开更多
文摘BACKGROUND Inguinal hernia is a common clinical manifestation in children with a low selfhealing rate.AIM To determine the effect of laparoscopic surgery on indirect inguinal hernia and the risk factors for postoperative recurrence and to provide a reference for the clinical treatment and prevention of recurrence.METHODS We selected 360 children who underwent laparoscopic high ligation in our hospital as the laparoscopic group and 120 patients treated for inguinal hernia with conventional surgery as the control group.The operation time,blood loss,incision length,hospitalization time,total hospitalization cost and surgical complications were compared between the two groups.According to telephone follow-up or return visits,the children who had recurrence within 2 years after the operation in the laparoscopic group were analyzed,and the laparoscopic high ligation hernia sac level was analyzed by the logistic multifactor method.Ligation was used to treat recurrence in children with inguinal hernia.RESULTS The operation time,blood loss,length of incision,and length of hospital stay in the laparoscopic group were lower than those in the control group(P<0.05).The total hospitalization cost in the laparoscopic group was higher than that in the control group(P<0.05).The operative complication rate was 1.67%lower than that in the control group(12.50%)(P<0.05).In 360 children with laparoscopic high ligation of the hernia sac,14 patients had recurrence within 2 years after surgery.After analysis,14 cases in the recurrence group did not recur.The preoperative incarceration rate,inner ring diameter,ligature use and age difference were statistically significant(P<0.05).According to logistic regression multivariate analysis,an inner ring diameter≥1.0 cm,the use of an absorbable ligature line and age>3 years increased the risk of postoperative recurrence in children with inguinal hernia after laparoscopic high ligation of the hernia sac(P<0.05).CONCLUSION Laparoscopic surgery for indirect inguinal hernia in children has the advantages of low trauma and a rapid postoperative recovery.An inner ring diameter≥1.0 cm,the use of absorbable ligature,and age>3 years may increase the risk of recurrence after laparoscopic high ligation of the hernia sac.
文摘目的探讨右美托咪定联合动画片干预对防治全麻腹腔镜疝囊高位结扎术患儿术后行为改变的临床意义。方法选取2020年4月—2022年12月择期行全麻腹腔镜疝囊高位结扎术的患儿270例为研究对象,根据就诊序号采用电脑随机数字表法分为A组(予以右美托咪定干预)、B组(予以动画片干预)、C组(予以右美托咪定联合动画片干预),每组90例。比较3组不同时间点平均动脉压(MAP)、心率(HR)、呼气末二氧化碳分压(P ET CO_(2))、血氧饱和度(SpO_(2))、呼吸频率(RR)、改良耶鲁围术期焦虑量表(mYPAS)评分以及诱导期合作度量表(ICC)评分、苏醒期躁动评分量表(PAED)评分、躁动发生率、苏醒情况、术后行为改变情况。结果在术前麻醉准备期间(T 2)、入手术室(T3)、术后苏醒即刻(T4),C组HR、MAP低于A组、B组(P<0.05)。3组P_(ET)CO_(2)、SpO_(2)、RR在组间、时间及组间·时间交互作用比较差异均无统计学意义(P>0.05)。T2、T3时,C组mYPAS评分低于A组、B组(P<0.05)。C组ICC、PAED评分及苏醒期躁动率低于A组、B组(P<0.05)。术后1、7 d,C组行为改变发生率低于A组、B组(P<0.05)。3组拔管时间、意识恢复时间、麻醉恢复室停留时间及不良事件总发生率比较差异无统计学意义(P>0.05)。结论右美托咪定联合动画片干预可降低行全麻腹腔镜疝囊高位结扎术患儿术前焦虑,提升患儿麻醉诱导合作程度,降低苏醒期躁动及术后行为改变发生率,且对患儿血流动力学影响较小,安全性高。
