兩種自制導線縫扎針在腹腔鏡小兒腹股溝疝手術中的應用_《華西醫學》

作者：

汪雪 ,  汪樹林

成都市第五人民醫院外一科（成都，611130）;

關鍵詞：

小兒腹腔鏡腹股溝疝雙孔導線縫針

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【摘要】　目的　探討自制雙孔導線針在腹腔鏡小兒腹股溝疝手術中的應用價值。　方法　回顧性分析2006年4月-2010年6月行腹腔鏡小兒腹股溝疝手術655例患兒的臨床資料。單孔針手術組452例，雙孔針手術組203例，將兩組患兒術中、術后資料進行對比分析。　結果　單孔針組手術時間(17. 7±3. 5) min；術中出血(5. 4±1. 3) mL，住院時間(2. 5±1. 0) d發生腹壁下小血腫15例，術后復發3例；雙孔針組手術時間(8. 2±2. 3) min，術中出血(1. 4±0. 3) mL，住院時間(2. 1±0. 8) d，發生腹壁下小血腫2例，術后復發1例。雙孔針組的手術時間、術中出血、并發癥發生率等均明顯優于雙孔針組(P lt;0. 05)，兩組住院天數、復發率差異均無統計學意義(P gt;0. 05)。　結論　自制雙孔導線縫扎針在腹腔鏡小兒腹股溝疝手術中應用能夠縮短手術時間，操作安全快捷，創傷更小等優點，值得推廣應用。
【Abstract】　Objective　 To explore the clinical value of self-made diplopore suture needle in laparoscopic herniorrhaphy in children.　Methods　 The clinical data of 655 patients who underwent laparoscopic herniorrhaphy between April 2006 and June 2010 were retrospectively analyzed. The patients were divided into the single-hole needle group (452 patients) and the diplopore needle group (203 patients), and the operative and post-operative data of the two groups were analyzed and compared.　Results　 The operation time in the single-hole needle group was (17.7±3.5) minutes and the bleeding volume during the operation was (5.4±1.3) mL; while 15 patients suffered from small hematoma under the abdominal wall and three recurred. The operation time in the diplopore needle group was (8.2±2.3) minutes with (1.4±0.3) mL blood loss; while two patients suffered from small hematoma under the abdominal wall and one recurred. The patients in the single-hole needle group stayed in the hospital for (2.5±1.0) days, while the patients in diplopore needle group stayed for (1.4±0.3) days. The operation time, bleeding volume, rate of complications in diplopore needle group were significantly less than those in the single-hole needle group (P lt;0.05). The hospital staying days, and the recurrence rate in the two groups didn’t differ much (P gt;0.05).　Conclusion　 The advantages of self-made diplopore needle in laparoscopic herniorrhaphy in children include short operation time, less trauma, and simple operation; it is worth generalizing and applying.

引用本文： 汪雪,汪樹林. 兩種自制導線縫扎針在腹腔鏡小兒腹股溝疝手術中的應用. 華西醫學, 2011, 26(3): 348-381. doi: 復制

1.	周欣, 王軍, 卞紅強, 等. 腹腔鏡下小兒腹股溝斜疝的內環口分型及臨床意義[J]. 中華小兒外科雜志, 2005, 26(11): 583-585.
2.	張志勇, 李慎惠, 徐家樸. 腹腔鏡下小兒疝囊高位結扎術初期疝復發探討[J]. 中國內鏡雜志, 2004, 10(9): 94-95.
3.	應福明, 馮雪峰. 腹腔鏡治療小兒斜疝97例[J]. 中國微創外科雜志, 2005, 5(6): 505-506.
4.	Gorsler CM, Schier F. Laparoscopic hemiorrhaphy in children[J]. Surg Endosc, 2003, 17(4): 571-573.
5.	孔赤寰, 王瑩, 張柏, 等. 單孔腹腔鏡下應用改型硬膜外針治療小兒腹股溝斜疝[J]. 中國微創外科雜志, 2009, 9(7): 587-588.
6.	Olguner M, Aktug T, Akgur F, et al. Exporimetal study inveseigating the feasibiling of a new method for laparoscopic indirect inguinal betnin repair[J]. J Invest Surg, 1997, 10(4): 189-193.
7.	Takehara H, Yakabe S, Kameoka, et al. Laparoscopic percutaneous extraperitonealclosure for inguinal hernia in children: clinical outcome of 972 repairs done in 3 pediatric surgical institutions[J]. J Pediatr Surg, 2006, 41(12): 1999-2003.
8.	Classen C, Palmes D, Horstmann R, et al. Laparoscopic inguinal herniorrhaphy in children-experiences in a primary medical care center[J]. Zentralbl Chir, 2008, 133(2): 178-181.
9.	Khajanchee YS, Urbach DR, Swanstrom LL, et al. Outcomes of laparoscopie hemiorrhaphy without fixation of mesh to the abdominal wall[J]. Surg Endosc, 2001, 15(10): 1102-1107.
10.	葉勁松, 侯東生, 張程鵬, 等. 兩孔提線針法微型腹腔鏡小兒腹股溝斜疝高位結扎術[J]. 腹腔鏡外科雜志, 2009, 14(5): 375.
11.	鐘先榮, 李金明, 劉振惠, 等. 兩孔法腹腔鏡小兒腹股溝斜疝高位結扎術120例報告[J]. 微創醫學, 2009, 4(2): 163.
12.	李永來, 劉煥軍, 李賀. 腹腔鏡下疝囊高位結扎術與傳統術式比較[J]. 中國微創外科雜志, 2007, 7(4): 376-377.

1. 　周欣, 王軍, 卞紅強, 等. 腹腔鏡下小兒腹股溝斜疝的內環口分型及臨床意義[J]. 中華小兒外科雜志, 2005, 26(11): 583-585.
2. 　張志勇, 李慎惠, 徐家樸. 腹腔鏡下小兒疝囊高位結扎術初期疝復發探討[J]. 中國內鏡雜志, 2004, 10(9): 94-95.
3. 　應福明, 馮雪峰. 腹腔鏡治療小兒斜疝97例[J]. 中國微創外科雜志, 2005, 5(6): 505-506.
4. 　Gorsler CM, Schier F. Laparoscopic hemiorrhaphy in children[J]. Surg Endosc, 2003, 17(4): 571-573.
5. 　孔赤寰, 王瑩, 張柏, 等. 單孔腹腔鏡下應用改型硬膜外針治療小兒腹股溝斜疝[J]. 中國微創外科雜志, 2009, 9(7): 587-588.
6. 　Olguner M, Aktug T, Akgur F, et al. Exporimetal study inveseigating the feasibiling of a new method for laparoscopic indirect inguinal betnin repair[J]. J Invest Surg, 1997, 10(4): 189-193.
7. 　Takehara H, Yakabe S, Kameoka, et al. Laparoscopic percutaneous extraperitonealclosure for inguinal hernia in children: clinical outcome of 972 repairs done in 3 pediatric surgical institutions[J]. J Pediatr Surg, 2006, 41(12): 1999-2003.
8. 　Classen C, Palmes D, Horstmann R, et al. Laparoscopic inguinal herniorrhaphy in children-experiences in a primary medical care center[J]. Zentralbl Chir, 2008, 133(2): 178-181.
9. 　Khajanchee YS, Urbach DR, Swanstrom LL, et al. Outcomes of laparoscopie hemiorrhaphy without fixation of mesh to the abdominal wall[J]. Surg Endosc, 2001, 15(10): 1102-1107.
10. 　葉勁松, 侯東生, 張程鵬, 等. 兩孔提線針法微型腹腔鏡小兒腹股溝斜疝高位結扎術[J]. 腹腔鏡外科雜志, 2009, 14(5): 375.
11. 　鐘先榮, 李金明, 劉振惠, 等. 兩孔法腹腔鏡小兒腹股溝斜疝高位結扎術120例報告[J]. 微創醫學, 2009, 4(2): 163.
12. 　李永來, 劉煥軍, 李賀. 腹腔鏡下疝囊高位結扎術與傳統術式比較[J]. 中國微創外科雜志, 2007, 7(4): 376-377.

《華西醫學》

兩種自制導線縫扎針在腹腔鏡小兒腹股溝疝手術中的應用

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《華西醫學》

兩種自制導線縫扎針在腹腔鏡小兒腹股溝疝手術中的應用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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Content

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