自制缝合针在腹腔镜小儿腹股沟斜疝疝囊高位结扎术中的应用临床医学.docVIP

自制缝合针在腹腔镜小儿腹股沟斜疝疝囊高位结扎术中的应用临床医学 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：自制缝合针在腹腔镜小儿腹股沟斜疝疝囊高位结扎术中的应用临床医学 1 1 资料与方法 2 2 结 果 3 3 讨 论 3 文2：临床护理路径在腹腔镜小儿腹股沟斜疝手术护理中的应用效果观察 5 1 资料与方法 5 2 结果 6 3 讨论 7 参考文摘引言： 7 原创性声明（模板） 8 文章致谢（模板） 9 正文 自制缝合针在腹腔镜小儿腹股沟斜疝疝囊高位结扎术中的应用临床医学 文1：自制缝合针在腹腔镜小儿腹股沟斜疝疝囊高位结扎术中的应用临床医学 【Abstract】 Ｏbjective:To evaluate the effect and complicatio of selfmade needle for indirect inguinal hernia under laparoscopic treatment in :Ninetythree children aged from 14 months to 13 yea were treated with selfmade needle by laparoscopic surgery for indirect inguinal hernia between March 2001 and December the patients were treated by high ligation of the hernial sac around the inner ring under :The operative procedure was operation time was （±）min and the mean length of stay was (±) cases recovered except 2 cases had the feeling of eyewinker in the operation incision didn t need suture and there was no obvious scar after :High ligation of the hernial sac with selfmade needle under laparoscope for the treatment of indirect inguinal hernia in children has the advantages of small incision,minimal injury,rapid recovery and short operation can find and deal with hidden patent internal recurrence and complicatio are uncommon,so it can be used widely. 【Key words】 Microlaparoscopy;Hernia,inguinal;Child;Selfmade needle 2001年3月至2007年12月，我院治疗腹股沟斜疝患儿共129例，其中用自制缝合针在腹腔镜下行疝囊高位结扎术治疗小儿腹股沟斜疝93例,效果良好。现报道如下。 1 资料与方法 临床资料 129例中男95例,女34例,14个月至13岁,均为腹股沟斜疝。93例行腹腔镜下疝囊高位结扎术，36例行常规疝囊高位结扎术。手术分组主要按收治患者的顺序，不具备腹腔镜条件的行常规手术。主要器械有微型腹腔镜,直径;操作钳,直径;穿刺套管,直径,均为国产腔镜器械。用直径的尖端带孔克氏针,前面部分稍磨平并弯曲成15°,制成缝合针。 手术方法 采用硬膜外加基础麻醉。腹腔镜组做2个小切口和1个小戳孔,1个切口在脐皱摺处,另1切口在脐旁3cm处,切口长度均为。戳孔位置在患侧内环口体表投影处,长。于脐皱摺处切口穿刺建气腹，置入腹腔镜,脐旁切口进操作钳,腹腔镜下找到患侧内环口,并在内环口体表投影的戳孔处刺入带7号丝线的自制缝合针,与操作钳配合缝合内环口内半周腹膜,带线针缝合时将缝线带入腹腔退出缝合针,再在戳孔处刺入带7号丝线自制缝合针与操作钳配合缝合外半周腹膜,将腹腔内的缝线置入刚刺入的缝线内,收紧缝线与缝合针一起退出戳孔并带出腹腔内第1根缝线,使内环口成荷包缝合,线结在戳孔处皮下,内环口即被关闭,在关闭内环口前要尽量挤出疝囊内的残余气体。解除气腹,手术结束,切口无需缝合。 2 结 果 患者手术当天麻醉完全清醒后均可进食，术后2例主诉腹股沟穿刺处有异物感，无疼痛，无其他并发症