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中华普通外科学文献(电子版)

中华普通外科学文献(电子版) ›› 2019, Vol. 13 ›› Issue (04) : 304 -307. doi: 10.3877/cma.j.issn.1674-0793.2019.04.011

所属专题： 文献；

论著

双孔与单孔腹腔镜疝修补术治疗儿童腹股沟疝的对比分析
曹闯1,†(), 吴江1, 黄庆荣1, 麦天赋1   
  1. 1. 524000　湛江，广东医科大学附属医院小儿外科
  • 收稿日期:2018-07-21 出版日期:2019-08-01
  • 通信作者: 曹闯
  • 基金资助:
    湛江市非资助科技攻关专题(湛科（2017）83号----2017B101)

Comparison of double-site laparoscopic hernia repair and single-site laparoscopic hernia repair in minimally invasive treatment of inguinal hernia in children

Chuang Cao1,†(), Jiang Wu1, Qingrong Huang1, Tianfu Mai1   

  1. 1. Department of Pediatric Surgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524000, China
  • Received:2018-07-21 Published:2019-08-01
  • Corresponding author: Chuang Cao
  • About author:
    Corresponding author: Cao Chuang, Email:
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曹闯, 吴江, 黄庆荣, 麦天赋. 双孔与单孔腹腔镜疝修补术治疗儿童腹股沟疝的对比分析[J]. 中华普通外科学文献(电子版), 2019, 13(04): 304-307.

Chuang Cao, Jiang Wu, Qingrong Huang, Tianfu Mai. Comparison of double-site laparoscopic hernia repair and single-site laparoscopic hernia repair in minimally invasive treatment of inguinal hernia in children[J]. Chinese Archives of General Surgery(Electronic Edition), 2019, 13(04): 304-307.

目的

比较双孔腹腔镜疝修补术（DSLH）与单孔腹腔镜疝修补术（SSLH）在儿童腹股沟疝微创治疗中的疗效。

方法

选取2012年12月至2015年12月间广东医科大学附属医院收治且经B超检查确诊的腹股沟疝患儿178例作为研究对象。其中89例接受DSLH治疗为DSLH组，89例接受SSLH治疗为SSLH组。比较两组患儿的治疗效果（手术时间、术中出血量、住院时间、术后下床活动时间、复发率）以及术后并发症的发生情况。

结果

相较DSLH组，SSLH组的手术时间、住院时间显著缩短（t=3.814、4.413，均P<0.001），术后下床活动时间更早（χ2=113.51，P<0.001），术中出血量少（t=4.012，P<0.001）；但是两组患儿的复发率及术后并发症的发生率差异无统计学意义（χ2=1.006、0.339，P=0.316、0.560）。

结论

SSLH较DSLH治疗效果更好，值得临床推广应用。

关键词: 疝，腹股沟, 双孔腹腔镜疝修补术, 单孔腹腔镜疝修补术, 疗效
Objective

To compare the efficacy of double-site laparoscopic hernia repair (DSLH) with single-site laparoscopic hernia repair (SSLH) in minimally invasive treatment of inguinal hernia in children.

Methods

A total of one hundred and seventy-eight children with inguinal hernia in the Affiliated Hospital of Guangdong Medical University from December 2012 to December 2015 who were confirmed by ultrasound examination were enrolled in this study. Among them, 89 patients who underwent DSLH were divided as the DSLH group, and the other 89 patients underwent SSLH treatment as the SSLH group. The treatment outcomes of the two groups (operation time, intraoperative blood loss, length of hospital stay, off-bed time, recurrence rates) and the occurrence rate of surgical complications were compared.

Results

In SSLH group, the operation time, hospitalization time, and off-bed time were significantly shortened (t=3.814, 4.413, χ2=113.510, all P<0.001), and the amount of intraoperative blood loss was reduced significantly than the patients in the DSLH group (t=4.012, P<0.001). However, there was no significant difference in the incidence of recurrence and surgical complications between the two groups (χ2=1.006, 0.339, P=0.316, 0.560).

Conclusion

SSLH can achieve better efficacy than DSLH and it is worthy of clinical application.

Key words: Hernia, inguinal, Double-site laparoscopic hernia repair, Single-site laparoscopic hernia repair, Efficacy
图1 单孔腹腔镜手术操作
图2 双孔腹腔镜手术操作
表1 两组腹股沟疝患儿术前临床资料的比较
组别 例数 年龄(岁，±s) 性别[例(%)] 位置[例(%)]
男 女 左侧 右侧 双侧
SSLH组 89 4.65±1.53 78(87.6) 11(12.4) 19(21.3) 59(66.3) 11(12.4)
DSLH组 89 4.32±1.49 79(88.8) 10(11.2) 20(22.5) 56(62.9) 13(14.6)
统计值 ? t=0.682 χ2=0.054 χ2=0.271
P值 ? 0.491 0.816 0.873
表2 两组腹股沟疝患儿手术情况的比较
组别 例数 手术时间(min，±s) 术中出血量(ml，±s) 下床活动时间[例(%)] 住院时间(d，±s) 复发[例(%)] 对侧隐性疝[例(%)]
<4 h ≥4 h
SSLH组 89 35.4±12.4 3.2±0.7 82(92.1) 7(7.9) 1.43±0.33 0(0) 19(21.3)
DSLH组 89 44.6±13.2 5.7±0.9 11(12.4) 78(87.6) 1.82±0.35 1(1.1) 17(19.1)
统计值 ? t=3.814 t=4.012 χ2=113.510 t=4.413 χ2=1.006 χ2=0.139
P值 ? <0.001 <0.001 <0.001 <0.001 0.316 0.709
表3 两组腹股沟疝患儿术后发生并发症的比较[例(%)]
组别 例数 伤口裂开 电解质紊乱 总并发症发生率
SSLH组 89 1(1.1) 0(0) 1(1.1)
DSLH组 89 1(1.1) 1(1.1) 2(2.2)
χ2值 ? 0.000 1.006 0.339
P值 ? 1.000 0.316 0.560
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