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目的通过对硬膜外导管针加以改进,自制成疝修补针应用于腹腔镜下小儿疝高位结扎术,对比小切口小儿疝高位结扎术,探讨其临床疗效,以明确腹腔镜技术应用于治疗小儿腹股沟疝的可行性、有效性、安全性。方法回顾性分析阜阳市人民医院普外科2014年4月—2016年4月收治的56例小儿腹股沟疝病例临床资料,并根据实施的手术方法分为2组,腹腔镜组28例运用改良疝修补针行腹腔镜下疝囊高位结扎术,小切口组28例行小切口疝囊高位结扎手术治疗,记录所有患儿术中及术后情况,比较2组手术时间、手术切口、术后并发症、术后复发率、住院时间等情况。数据采用SPSS 19.0统计软件进行分析处理,P<0.05为差异有统计学意义。结果自制硬膜外导管针腹腔镜下疝囊高位结扎手术较小切口疝囊高位结扎术手术时间明显缩短(t=5.441、P<0.001),腹腔镜下疝囊高位结扎手术切口小(t=5.403、P<0.001),腹腔镜下疝囊高位结扎术组患儿较小切口组患儿术后并发症明显减少(χ~2=4.082、P=0.043),差异有统计学意义(P<0.05),术后复发率(χ~2=1.018、P=0.313)及住院天数(t=0.928、P=0.357)差异无统计学意义(P>0.05)。结论通过改进硬膜外导管针、自制成疝修补针应用于腹腔镜下小儿疝囊高位结扎术,具有手术时间短、手术切口小、术后并发症少等特点,术中视野清晰开阔,并可发现对侧隐匿性疝,同时可进行腹腔探查,且安全可靠,为儿童腹股沟斜疝治疗提供新的思路与方法,同时得到了患儿家长的认同,值得临床推广。
Objective To improve the performance of epidural catheter, made of self-made hernia repair needle used in laparoscopic high ligation of children with hernia, compared with small incision in children with high ligation of hernia to explore its clinical efficacy in order to identify the application of laparoscopy in the treatment The feasibility, effectiveness and safety of infantile inguinal hernia. Methods The clinical data of 56 cases of children with inguinal hernia admitted from April 2014 to April 2016 in General Surgery of People’s Hospital of Fuyang City were retrospectively analyzed. According to the operation method, the patients were divided into two groups. In the laparoscopic group, 28 cases were treated with modified hernia repair The patients underwent laparoscopic high ligation of the hernia sac. Twenty-eight patients underwent small incision hernia sac undergoing high ligation. All patients were recorded intraoperatively and postoperatively. The operative time, surgical incision, postoperative complications , Postoperative recurrence rate, hospitalization time and so on. Data were analyzed by SPSS 19.0 statistical software, P <0.05 was considered statistically significant. Results The laparoscopic high-level ligation of laparoscopic high-grade ligation of the epidural catheter showed that the operative time was significantly shortened (t = 5.441, P <0.001), and the laparoscopic high ligation of the hernia sac was less (t = 5.403, P <0.001). The incidence of postoperative complications was significantly decreased in children with small incision in laparoscopic high ligation group (χ ~ 2 = 4.082, P = 0.043), the difference was statistically significant (P < 0.05). The recurrence rate (χ ~ 2 = 1.018, P = 0.313) and length of hospital stay (t = 0.928, P = 0.357) showed no significant difference (P> 0.05). Conclusion By improving the epidural catheter needle, made of self-made hernia repair needle for laparoscopic high ligation of children with hernia sac, with short operation time, small incision, less postoperative complications, clear and wide field of vision, And can be found on the contralateral occult hernia, at the same time be able to carry out abdominal exploration, and safe and reliable, for the treatment of children with inguinal hernia provides a new way of thinking, at the same time get the recognition of children with parents, is worthy of clinical promotion.