单孔腹腔镜鞘状突高位结扎术治疗鞘膜积液患儿的疗效

Efficacy of Single-port Laparoscopic High Ligation of the Vaginal Process in the Treatment of Hydrocele in Children

摘要:

〔摘 要〕 目的：探究单孔腹腔镜鞘状突高位结扎术治疗鞘膜积液患儿的临床效果。方法：选取 2016 年 3 月至 2021 年 3 月于福州儿童医院治疗的 260 例鞘膜积液患儿，随机数字表法将患儿分为腹腔镜组与传统组，各 130 例。 腹腔镜组予以单孔腹腔镜鞘状突高位结扎术，传统组实施常规开放手术，比较两组患儿围术期指标、切口愈合情况、 儿童行为疼痛量表评分、并发症情况及术前、术后 1 d、3 d 炎症水平。结果：腹腔镜组患儿切口长度、手术时间、住 院时间均短于传统组，术中出血量少于传统组，并发症总发生率低于传统组，差异具有统计学意义（P ＜ 0.05）；腹 腔镜组患儿切口愈合情况甲级、无痛人数占比高于传统组，乙级、丙级、轻微不适、中度疼痛、重度疼痛人数占比低 于传统组，差异具有统计学意义（P ＜ 0.05）；两组患儿术后 1 d、3 d 的超敏 C 反应蛋白（hs–CRP）、白细胞介素 –6 （IL–6）、肿瘤坏死因子 –α（TNF–α）水平高于术前，且腹腔镜组患儿术后 1 d、3 d 的 hs–CRP、IL–6、TNF–α 均低 于传统组，差异具有统计学意义（P ＜ 0.05）。结论：单孔腹腔镜鞘状突高位结扎术治疗鞘膜积液能优化手术情况， 减轻炎症发应，缓解患儿疼痛，有助于术后恢复，缩短住院时间，提高治疗安全性。

Abstract:

〔Abstract〕 Objective To investigate the clinical effect of single-port laparoscopic high ligation of the vaginal process in the treatment of hydrocele in children. Methods A total of 260 children with hydrocele treated in Fuzhou Children's Hospital from March 2016 to March 2021 were selected. The children were divided into laparoscopic group and traditional group by random number table method, with 130 cases in each group. The laparoscopic group was treated with single-port laparoscopic high ligation of vaginal process, while the traditional group was treated with conventional open surgery. Perioperative indicators, incision healing, children's behavioral pain scale score, complications, and inflammation levels before and after surgery at 1 and 3 days were compared between the two groups. Results The incision length, operation time and hospital stay in the laparoscopic group were shorter than those in the traditional group, the amount of intraoperative blood loss was less than that in the traditional group, and the total incidence of complications were lower than those in the traditional group, with statistical significances (P < 0.05). The proportions of grade A and wound healing and painless patients in the laparoscopic group were higher than those in the traditional group, and the proportions of grade B and C, mild discomfort, moderate pain and severe pain were lower than those in the traditional group, with statistical significances (P < 0.05). The levels of hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in the two groups at 1d and 3d days after operation were higher than those before operation, and the levels of hs-CRP, IL-6 and TNF-α in the laparoscopic group at 1d and 3d days after operation were lower than those in the traditional group, the differences were statistically significant (P < 0.05). Conclusion Single-port laparoscopic high ligation of the vaginal process for hydrocele can optimize the operation, reduce inflammation, relieve pain in children, contribute to postoperative recovery, shorten the hospital stay, and improve the safety of treatment.