腹腔镜急诊手术与择期手术治疗小儿腹股沟疝的临床价值

摘要

Objective To explore the clinical value of laparoscopic emergency operation and selective operation in the treatment of pediatric inguinal hernia.Methods 198 children with inguinal hernia treated in Nanning Sixth Peoples's Hospital from January 2014 to December 2017 were selected as the study subjects.According to the timing of operation,they were divided into the emergency operation group (n=102) and the selective operation group (n=96).The operation time (min),tissue injury,supplementary diagnosis,anesthesia risk and complications incidence were compared between the two groups.Results The operation time of emergency operation group was significantly longer than that of selective operation group (P＜0.05).The incidence of tissue injury in the emergency operation group was higher than that in the selective operation group (P＜0.05).The supplementary diagnosis of laparoscopic exploration in emergency operation group was lower than that in selective operation group (P＜0.05).The risk of anesthesia in the emergency operation group was higher than that in the selective operation group (P＜0.05).The incidences of hydrocele,testicular atrophy and recurrence in emergency operation group were higher than those in the selective operation group (P＜0.05).Conclusions Under fully considering the child's condition and whether there are independent risk factors of incarceration or indirect hernia,the choice of selective surgery has a better surgical effect.%目的 探讨腹腔镜急诊手术与择期手术治疗小儿腹股沟疝的临床价值.方法 选取2014年1月至2017年12月,广西南宁市第六人民医院因腹股沟疝进行救治的患儿198例作为研究对象,根据手术时机不同分为急诊手术组(102例)及择期手术组(96例),对比分析2组手术时间、组织损伤情况、补充诊断、麻醉风险及术后3个月随访并发症发生率.结果 急诊手术组手术时间较择期手术组时间显著延长,且患儿组织损伤发生率高于择期手术组,腹腔镜探查补充诊断情况低于择期手术组,麻醉风险较择期手术组高,差异均有统计学意义(P＜0.05).急诊手术组患儿鞘膜积液发生率、睾丸萎缩发生率、术后复发率均高于择期手术组,差异均有统计学意义(P＜0.05).结论 在充分考虑患儿病情及是否存在嵌顿及斜疝独立危险因素的前提下,选择择期手术具有较好手术效果.