刘建刘彦祝东强刘恒.DOCVIP

自制导线针在腹腔镜小儿腹股沟斜疝 疝囊高位结扎术中的应用 刘建，刘彦，祝东强，刘恒 （四川省成都市第五人民医院普外科，四川，611130） 【摘要】 目的：通过与传统切开疝修补术比较，评价自制导线针在小儿腹股沟斜疝腹腔镜治疗中的疗效及并发症。 方法：260名腹股沟斜疝的儿童（嵌顿疝并行急诊传统手术者除外）分为两组：以2004年10月为界，之前入院的120例行传统切开疝修补术(对照组)，之后入院的140例应用自制导线针针行腹腔镜下疝囊高位结扎术（腹腔镜组），比较手术时间、术后伤口疼痛持续时间、术后并发症发生率（伤口出血、感染，尿潴留，血管、输精管及神经损伤，阴囊血肿、皮下血肿等)、出院后随访复发率（30个月)。 结果：应用自制缝合针为140例患儿行微型腹腔镜小儿腹股沟斜疝疝囊高位结扎术，手术过程顺利，与传统手术相比，手术时间、住院时间、切口疼痛持续时间明显更短(P0．01)、并发症发生率更低(P0．05)、复发率和住院费用则无明显差异(P0．05)。 结论：应用自制导线针行腹腔镜小儿腹股沟斜疝疝囊高位结扎术，切口小，损伤轻，疼痛轻，恢复快，手术时间及住院时间短，操作简单，安全，疗效可靠，可同时发现及处理对侧隐性内环口未闭，复发率低，并发症少，值得临床推广应用。 【关键词】微型腹腔镜；疝；腹股沟；儿童；自制导线针 Application of Self-made needle for Oblique inguinal hernia under Laparoscopic High ligation of the Hernial sac in Children LIU Jian，LIU Yan，ZHU Dong-qiang， LIU Heng (Department of General Surgery, The 5th Hospital of Chengdu，Chengdu, Sichuan Province, 611130) 【Abstract】 Objective：To evaluate the effect and complications of self-made needle for Oblique inguinal hernia under laparoscopic treatment in children compared with traditional herniorrhaphy by cutting-off abdominal wall. Methods:260 children who have Oblique inguinal hernia( Aeb. 2000 to Aug. 2008, except for children who have incarceration and treated with emergent traditional herniorrhaphy) were divided to two groups :having the Oct. 2004 as the boundary,120 children before it were were treated with traditional herniorrhaphy(control group), 140 children after it were were treated by high ligation of the hernial sac around the inner ring under laparoscope(abdominoscope group).Contrasting time of operation ,time of pain after operation ,the rate of complication(hemorrhage, infection, urine retention, injury to blood vessels, deferent ducts and nerves, hematoma of scrotum, ecchymoma and so on).Doing follow-up visit of recidivation (30 months). Results：140 children were treated with self-made needle by laparoscopic surgery for Oblique inguinal hernia .The operative procedure was uneventfu1．Compared with the operation opened abdominal cavity, the process