【摘要】 目的比较传统手术、小切口手术和腹腔镜手术治疗小儿腹股沟疝的临床疗效和并发症。方法回顾性分析2005年1月至2016年12月中山大学附属第五医院和珠海市妇幼保健医院收治的413例腹股沟疝患儿,其中传统组145例,小切口组112例,腹腔镜组156例。比较不同手术方式治疗的手术时间、术中出血量、自主活动时间、住院时间、术后疼痛评分、切口疼痛不适发生率、切口感染率、继发性鞘膜积液发生率和疝复发率等。结果腹腔镜组在手术时间、出血量、术后疼痛评分、自主活动时间、术后住院时间和平均住院费少于传统组和小切口组,差异均有统计学意义(F=11.616、15.865、9.740、8.612、6.207、3.113,均P<0.05);腹腔镜组在阴囊血肿率、切口感染率、切口疼痛发生率、鞘膜积液发生率和复发率方面均低于传统组和小切口组,差异有统计学意义(χ~2=7.175、6.714、11.071、8.252、6.470,均P<0.05)。结论腹腔镜手术在小儿腹股沟疝中优势明显,且风险不高,对于有条件的医院鼓励开展,以减少局部创伤和一些并发症的发生。更多还原

【Abstract】 Objective To compare the clinical efficacy and complications of traditional surgery,small incisional and laparoscopy in the treatment of inguinal hernia in children.Methods Four hundred and thirteen cases of hernia were retrospectively analyzed from January 2005 to December 2016 in the Fifth Affiliated Hospital of Sun Yat-sen University and Zhuhai Maternal and Child Health Hospital.According to the surgical methods,there were 145 cases in the traditional group,112 in the small incision group and 156 in the laparoscopic group.The operative time,blood loss,activity time,hospitalization time,postoperative pain score,incidence of incision pain,infection rate of incision,incidence of secondary hydrocele and recurrence rate of hernia were compared.Results For laparoscopic group,operation time,bleeding volume,postoperative pain score,independent activity time,hospitalization time and average hospitalization cost were all respectively less than the traditional group and small incision group,with statistical differences(F=11.616,15.865,9.740,8.612,6.207,3.113,all P<0.05).For laparoscopic group,hematoma of scrotum rate,wound infection rate,incision pain incidence,recurrence rate and incidence of hydrocele were all lower than the traditional group and small incision group,with statistical differences(χ~2=7.175,6.714,11.071,8.252,6.470,all P<0.05).Conclusions Laparoscopic surgery has obvious advantages and low risk in pediatric inguinal hernia.It can be encouraged for the conditional hospitals to reduce the occurrence of local trauma and some complications.更多还原