腹横纹小切口与传统手术对儿童腹股沟疝的疗效及安全性对比

目的比较腹横纹小切口与传统手术对儿童腹股沟疝的疗效及安全性。方法回顾性分析2010年6月至2013年6月，湖北民族学院附属民大医院收治的400例腹股沟疝患儿，随机分为改进组201例，传统组199例。改进组采用腹横纹小切口术，传统组采用传统手术方式。比较二组的手术情况及预后情况。结果改进组的手术时间为（24±5）min，切口长度为（2．1±0．2）cm，术中出血量为（5．3±2．5）ml，平均住院时间为（3±1）d；传统组的手术时间为（46±10）min，切口长度为（3．6±0．3）em，术中出血量为（14．1±3．6）ml，平均住院时间为（7±1）d，以上指标二组比较差异均有统计学意义（t=2．580、1．984、2．347、2．813，P=0．011、0．049、0．019、0．005）。改进组患儿的术后恢复正常活动时间为（3．2±0．4）d，无阴囊血肿，疝复发1例（0．5％）；传统组患儿的术后恢复正常活动时间为（8．7±1．6）d，阴囊血肿9例（4．5％），疝复发6例（3．0％）二组比较差异均有统计学意义（t=2．213，r=6．617、5．012，P=0．027、0．011、0．026）。结论腹横纹小切口术在儿童腹股沟疝的治疗上取得的效果更好，安全性更高，具有明显的优势，值得在临床上推广和应用。

Efficacy and safety analysis of small- incision hernia repair and traditional operation for children with inguinal hernia

Objective To compare the outcome and safety between small-incision hernia repair and traditional operation for inguinal hernia in children. Methods From June 2010 to June 2013, a total of 400 cases of inguinal hernia in children were collected in this study, including 201 cases received the smallincision repair in the modified group and 199 cases received traditional operation in the traditional group. The operation states and outcomes were compared between the two groups. Results In the modified group, the operating time was （24 ±5） minutes, length of incision was （2. 1 ± 0.2） cm, the average bleeding was （5.3 ± 2.5） ml, and the mean length of hospitalization stay was （3 ± 1） days; while those in the traditionai group, was （46 ± 10） minutes, （3.6 ±0.3） cm, （14.1 ±3.6） ml, and （7± 1） days, respectively. And those differences was statistically significant （t = 2. 580,1. 984,2. 347,2. 813 ,P = 0. 011, 0.049,0. 019,0. 005）. The patients in the modified group return to physical activity in （3.2 ±0.4） days, no scrotal hematoma was found, and recurrence occurred in 1 case （0.5%）. Children in the traditional group took （8.7 ± 1.6） days to return to normal activity, and scrotal hematoma and recurrence occurred in 9 cases （4.5%） and 6 cases （ 3.0% ）, respectively. The differences between the two groups were significant （t=2.213,X2 =6. 617,5.012,P=0.027,0.011,0.026）. Conclusion Small-incision hernia repair for inguinal hernia in children has shown to have obvious advantages in terms of efficacy and safety, which is worthy of clinical promotion.