阴囊小切口治疗小儿腹股沟斜疝与传统手术对比分析

目的探讨阴囊小切口及传统的经腹股沟切口治疗小儿腹股沟斜疝的临床效果。方法腹股沟斜疝患儿256例,治疗组136例应用阴囊小切口行疝囊高位结扎;对照组120例应用经腹股沟切口行疝囊高位结扎。对比分析2种术式的麻醉方法、手术方式及临床疗效。结果手术均在监护性麻醉(monitored anesthesia care,MAC)下进行,256例手术均获成功,治疗组手术时间5～10 min,平均6.5 min;切口长1～1.5 cm,术后无明显切口痛,无手术并发症;住院时间一二天;129例得到随访,随访率94.8%,术后随访6个月～3 a无复发。对照组手术时间20～40 min,平均31.2 min;切口长3～5 cm;术后切口痛1～3 d,阴囊小血肿1例;住院时间4～7 d;109例得到随访,随访率90.8%,术后随访6个月～3年1例复发。结论阴囊小切口治疗小儿腹股沟斜疝较传统疝手术切口小且隐匿、不破坏腹股沟区解剖,麻醉安全,手术时间短,恢复快,费用低,是治疗小儿腹股沟斜疝的好方法,值得临床推广,特别适合在基层医院开展。

Comparative analysis of scrotal incision in the treatment of pediatric indirect inguinal hernia with traditional surgery

Objective]To discuss the clinical effect of small incision scrotum and traditional inguinal incision for the treatment of indirect inguinal hernia in children.Methods]A total of 256 cases of the male inguinal indirect hernia in children were divided into the treatment group of 136 cases receiving scrotum and small incision of high ligation of hernial sac and the control group of 120 cases receiving high ligation of hernial sac of inguinal incision.Comparative analysis was conducted on anesthesia method,operation mode and clinical efficacy of 2 methods.Results] Operation was performed on 256 cases under monitoring anesthesia（monitored anesthesia care,MAC）,all were successful,the operation time of treatment group was 5-10 minutes,6.5minutes in average,incision length 1-1.5 cm,without obvious postoperative incision pain and operation complications,hospitalization time of 1-2 days,129 cases（94.8%） were followed up,without recurrence after 6 months to 3 years follow-up.The operation time of control group was 20-40 minutes,31.2 minutes in average,incision length 3-5 cm,postoperative incision pain in 1-3 days,1 case with scrotal hematoma,hospitalization time of 4-7 days,109 patients（90.8%）received follow-up,1 case recurrence after 6 months to 3 years follow-up.Conclusion]Scrotal incision in the treatment of indirect inguinal hernia in children,compared with the traditional hernia operation incision,is small and hidden,does not destroy the anatomy of inguinal region,with characteristics of the safety of anesthesia,short operation time,rapid recovery,low cost.It is a good method for the treatment of indirect inguinal hernia in children,and worthy of clinical application,particularly suitable for primary hospitals.