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目的总结探讨微型腹腔镜治疗小儿疝气的临床效果和手术安全性。方法 90例疝气患儿,根据手术方式分为腹腔镜组和开放手术组,各45例。腹腔镜组给予微型腹腔镜手术,开放手术组给予开放手术。观察两组患儿临床治疗效果、手术时间、术中出血量、自主活动时间、切口长度、术后并发症等指标。结果腹腔镜组出血量(12.5±1.6)ml少于开放手术组的(15.6±2.9)ml,切口长度(1.5±0.2)cm短于开放手术组的(4.5±1.2)cm,手术时间(17.5±1.2)min、术后自主活动时间(12.6±3.5)h、术后排气时间(6.9±1.5)h、住院时间(3.2±1.1)d均明显短于开放手术组的(22.5±2.6)min、(22.5±2.1)h、(8.5±1.9)h、(5.2±1.3)d,差异均具有统计学意义(P<0.05)。腹腔镜组术后并发症发生率6.67%、术后1年复发率2.22%明显低于开放手术组的22.22%、13.33%,差异具有统计学意义(P<0.05)。结论与传统开放手术相比,微型腹腔镜手术在小儿疝气治疗中优势明显,具有微创、手术用时短、术后快速恢复、并发症发生率低等优势,手术安全性更高,值得推广使用。
Objective To summarize the clinical effect and operative safety of mini laparoscopic treatment of pediatric hernia. Methods 90 cases of children with hernia were divided into laparoscopic group and open surgery group according to the operation method, 45 cases in each group. Laparoscopic group was given mini laparoscopic surgery, and open surgery group was given open surgery. The clinical effects, operation time, intraoperative blood loss, independent activity time, incision length and postoperative complications were observed in two groups of children. Results The bleeding volume in laparoscopic group (12.5 ± 1.6) ml was less than that in open surgery group (15.6 ± 2.9) ml, and the length of incision (1.5 ± 0.2 cm) was shorter than that in open surgery group (4.5 ± 1.2 cm) ± 1.2) min, postoperative autonomic activity (12.6 ± 3.5) h, postoperative exhaust time (6.9 ± 1.5) h, hospital stay (3.2 ± 1.1) d were significantly shorter than those in open surgery group (22.5 ± 2.6) min, (22.5 ± 2.1) h, (8.5 ± 1.9) h, (5.2 ± 1.3) d, respectively. The difference was statistically significant (P <0.05). The incidence of postoperative complications in laparoscopic group was 6.67%, the recurrence rate at 1 year after surgery was 2.22% which was significantly lower than that of open surgery group (22.22%, 13.33%, P <0.05). Conclusion Compared with the traditional open surgery, micro-laparoscopic surgery has obvious advantages in the treatment of pediatric hernia, which has the advantages of minimally invasive, short operative time, rapid recovery after operation, low complication rate and safety of operation, which is worthy of popularization .