论文部分内容阅读
目的:探讨与行腹腔镜下疝囊高位结扎术斜疝患儿术后复发的因素。方法:收集2013年1月—2016年1月期间行腹腔镜下疝囊高位结扎术的306斜疝患儿临床资料,对影响患儿术后复发的相关危险因素进行统计学分析。结果:306例患儿(401侧)中,13例复发,复发率为3.24%。单变量分析显示,斜疝患儿的年龄、内环口直径和结扎线的选择与腹腔镜下疝囊高位结扎术术后复发有关(χ~2=6.275、9.145、11.371,P=0.043、0.010、0.001);多变量Logistic回归分析显示,年龄与内环口直径较大以及用可吸收线结扎是腹腔镜下疝囊高位结扎术术后复发的独立危险因素(OR=3.466,95%CI=1.432~8.389;OR=1.988,95%CI=1.237~3.194;OR=1.089,95%CI=1.015~1.168,均P<0.05)。结论:年龄与内环口直径较大以及可吸收线的使用是导致斜疝患儿行腹腔镜下疝囊高位结扎术术后复发的主要危险因素,对存在危险因素的患儿应考虑改良的腹腔镜手术方法、加强术后监护,并避免使用可吸收线,减少复发的发生。
Objective: To investigate the factors of postoperative recurrence in children with oblique hernia after laparoscopic high ligation of hernia sac. Methods: The clinical data of 306 children with oblique hernia underwent laparoscopic high ligation of hernia sac between January 2013 and January 2016 were collected and the related risk factors affecting postoperative recurrence were analyzed. Results: Among 306 children (401 sides), 13 cases relapsed with a recurrence rate of 3.24%. Univariate analysis showed that the age, the diameter of the internal annulus and the choice of ligature of the children with oblique hernia were related to the recurrence after laparoscopic high ligation (χ ~ 2 = 6.275,9.145,11.371, P = 0.043,0.010 , 0.001). Multivariate logistic regression analysis showed that the larger diameter and the diameter of the internal orifice and the absorbable ligation were the independent risk factors for recurrence of laparoscopic high ligation (OR = 3.466, 95% CI = OR = 1.988, 95% CI = 1.237 ~ 3.194; OR = 1.089, 95% CI = 1.015 ~ 1.168, all P <0.05). Conclusion: The age and the diameter of the inner mouth and the use of the absorbable line are the main risk factors for the recurrence of laparoscopic hernia sac in patients with oblique hernia after operation. The children with risk factors should consider the improved Laparoscopic surgery to strengthen postoperative care, and avoid the use of absorbable lines to reduce the incidence of recurrence.