经脐单孔腹腔镜疝修补术治疗嵌顿性腹股沟斜疝患儿的效果

曹瑞萌,张 昭,赵腾府

(濮阳市人民医院小儿外科,河南 濮阳 457000)

摘要 目的:探讨经脐单孔腹腔镜疝修补术在嵌顿性腹股沟斜疝患儿治疗中的效果。 方法:以 86 例嵌顿性腹股沟斜疝患儿为研究对象,按照治疗方法不同将其分为两组。 对照组 43 例,接受传统术式治疗;研究组 43 例,接受经脐单孔腹腔镜疝修补术治疗。 观察两组术中失血量、首次排气时间、住院时间及并发症,分析两组疼痛程度及血清白细胞介素-6(IL-6)、C 反应蛋白(CRP)水平。 结果:研究组住院时间、手术时间、首次排气时间均短于对照组,术中失血量少于对照组,差异均有统计学意义(P<0.05);研究组术后疼痛 FLACC 评分,血清 CRP、IL-6 水平低于对照组(P<0.05);研究组并发症发生率 4.65%低于对照组 23.3%(P<0.05)。 结论:经脐单孔腹腔镜疝修补术明显提高嵌顿性腹股沟斜疝患儿的治疗效果。

关键词: 经脐单孔腹腔镜疝修补术;嵌顿性腹股沟斜疝;疼痛程度;并发症

中图分类号:R726.5 文献标志码:A 文章编号:1008-2409(2022)03-0049-04

Effect of transumbilical single-port laparoscopic hernia repair for children with incarcerated oblique inguinal hernia

CAO Ruimeng, ZHANG Zhao, ZHAO Tengfu. (Dept. of Pediatric Surgery, Puyang People’ s Hospital, Puyang 457000, China)

Abstract Objective: To discuss the effect of transumbilical single-port laparoscopic hernia repair for children with incarcerated oblique inguinal hernia. Methods: 86 cases of patients with incarcerated oblique inguinal hernia were divided into two groups, each with 43 cases. The control group received conventional treatment, while the study group received transumbilical single-port laparoscopic hernia repair. Then, the intraoperative blood loss, first exhaust time, length of hospital stays and complications were compared between both groups; and the degree of pain and the levels of serum interleukin-6(IL-6)and C-reactive protein(CRP)in both groups were analyzed. Results: The length of hospital stays, operation duration, intraoperative blood loss and first exhaust time in the observation group was shorter than that in control group, and the amount of intraoperative blood loss was less than that of the control group, which were of statistical differences between patients in both groups(P<0.05); after surgery, the FLACC score of postoperative pain, levels of serum CRP and IL-6 in the study group was lower than those in the control group(P<0.05); and the incidence of complications in the study group was 4.65%, lower than 23.3% in the control group ( P < 0. 05). Conclusion: Transumbilical single-port laparoscopic hernia repair can significantly improve the therapeutic effect in patients with incarcerated oblique inguinal hernia.

Keywords: transumbilical single-port laparoscopic hernia repair; incarcerated oblique inguinal hernia; pain degree; complications

参考文献:

[1] SHALABY R,ABD ALRAZEK M,ELSAIED A,et al.Fifteen years experience with laparoscopic inguinal hernia repair in infants and children[J].J Laparoendosc Adv Surg Tech A, 2018,28(1):101-105.

[2] 万琦文,石英佐,张亦鹏.腹腔镜疝囊高位结扎术与传统开放式疝囊高位结扎术治疗小儿腹股沟疝的疗效及成本比较[J].新乡医学院学报,2017,34(8):745-747.

[3] YANG Q,GAO Y.Incarcerated recurrent inguinal hernia as a cause of secondary torsion of the greater omentum:a rare case report and literature review[J].J Int Med Res,2019,47 (11):5867-5872.

[4] 杨周健,刘钧,向波,等.开放手术与腹腔镜下手术治疗新生儿嵌顿性腹股沟斜疝的临床疗效比较[J].中国内镜杂志,2019,25(9):70-74.

[5] 常建华,张世平,王臻,等.丙泊酚联合七氟烷对扁桃体切除术患儿麻醉苏醒期血流动力学及躁动情绪影响研究[J].陕西医学杂志,2018,47(7):908-911.

[6] MASOUDIAN P,SULLIVAN K J,MOHAMED H,et al.Optimal timing for inguinal hernia repair in premature infants:a systematic review and meta-analysis [ J]. J Pediatr Surg, 2019,54(8):1539-1545.

[7] 徐晓青,杨广承.单孔腹腔镜下应用小儿活动拉钩与下腹壁小切口治疗小儿腹股沟斜疝疗效及并发症比较[J].河北医学,2019,25(11):1843-1846.

[8] 肖雅,罗雪松,喻正波.腹腔镜手术治疗小儿嵌顿性腹股沟斜疝的临床疗效及安全性研究[J].齐齐哈尔医学院学报,2018,39(1):46-48.

[9] 王燕惠,曾祥鑫,陈锦荣,等.单孔腹腔镜与传统开放手术疝囊高位结扎术治疗小儿腹股沟斜疝的对比分析[J].腹腔镜外科杂志,2020,25(7):512-515,519.

[10] 高林,仲卫东,宣卓琦.改良单孔腹腔镜疝囊高位结扎术在婴幼儿腹股沟斜疝中的应用体会[J].腹腔镜外科杂志,2019,24(2):88-91.

[11] 田飞,郭朝,魏强.经脐单孔腹腔镜疝修补术治疗嵌顿性腹股沟斜疝的效果及安全性[J].新乡医学院学报,2019,36(6):571-573.

[12] 孙洁.完整结肠系膜切除术治疗老年结肠癌的临床疗效及对患者血清 CRP、TNF-α 和 IL-6 水平的影响[J].实用癌症杂志,2019,34(3):393-396.

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