目的 了解局部麻醉下腹股沟疝无张力修补术后患者排便变化的相关影响因素。 方法 采用自行设计的问卷调查表,对2010年5月-6月行无张力修补术的腹股沟疝患者术后排便情况及变化进行调查,并就相关影响因素采用logistic回归方法进行统计分析。 结果 腹股沟疝无张力修补术后患者进食量减少、活动量减少、饮食成分变化、担心排便引起复发是术后排便变化的影响因素。 结论 加强该病症术后健康宣传,指导患者正常进食、多活动,消除患者对腹股沟疝复发的焦虑,可促进其早期排便。Objective To research on the risk factors for change of defecation after inguinal hernia mesh-repairs under local anesthesia. Methods Self-made questionnaires were used to investigate the defecation change among patients having undergone inguinal hernia mesh-repairs from May to June 2010, and the correlated factors for change of defecation were analyzed by logistic regression analysis. Results Reduction of activity and food, changes of food ingredients, and worries about recurrence were risk factors for change of defecation. Conclusion In order to facilitate the recovery of the patients, nurses should promote patients’ knowledge on the surgery, guide them to eat as usual and do more exercises, and eliminate their anxiety on recurrence of the disease.
目的 探讨小儿腹股沟斜疝行缩小内环口的手术治疗效果。方法 对我院1994~1999年285例小儿腹股沟斜疝行疝囊高位结扎+内环口修补的资料进行回顾性分析。结果 285例患者全部于术后5~7天拆线,痊愈出院,无严重并发症发生。有267例获随访,随访率93.7%,随访时间1~5年。术后复发2例,复发率0.7%。结论 在对小儿腹股沟斜疝行传统的疝囊高位结扎基础上加行内环修补术,手术操作简便,能有效提高疗效,降低术后复发率。
目的:探讨医源性隐睾的病因,预防和治疗特点。方法:回顾分析我院治疗的16 例医源性隐睾患儿,其中睾丸鞘膜积液术后7 例,腹股沟斜疝术后8 例,尿道下裂术后1 例。结果:16 例均接受手术治疗,10 例睾丸存在不同程度的萎缩,其中1 例睾丸完全萎缩,行睾丸切除。术后随访12 例,睾丸均在阴囊内,但发育较健侧差。结论:降低医源性隐睾发病率的根本措施是防止其发生,尽量减少不正确的医疗行为,并做到早期发现,早期行手术治疗。
目的 总结双孔法腹腔镜疝囊高位结扎术治疗小儿腹股沟斜疝的疗效及经验。方法 2010年3月至2012年4月期间我院对89例小儿腹股沟斜疝患儿采用双孔法腹腔镜下疝囊高位结扎术。结果 89例在腹腔镜下完成疝囊高位结扎术,每侧手术时间3~6min,平均4min。13例患儿存在对侧隐性疝,一并行疝囊高位结扎术。术后随访3~12个月,平均10个月,无一例复发,无阴囊红肿及阴囊积气病例。结论 双孔法腹腔镜疝囊高位结扎术治疗小儿腹股沟斜疝效果满意。
目的探讨自制双孔缝合针在腹腔镜下治疗小儿疝囊高位结扎术中的临床价值。方法对2008年5月至2010年5月期间在成都市第五人民医院收治的237例腹股沟斜疝儿童应用自制双孔缝合针在腹腔镜下行疝囊高位结扎术治疗的临床资料进行回顾性分析。结果237例均在腹腔镜下完成疝囊高位结扎术。单侧手术181例,时间5~7 min,平均5.8 min; 双侧56例,手术时间7~12 min,平均9.1 min。术后均无局部血肿、阴囊水肿、阴囊积气、切口感染、皮下异物感等并发症发生。术后随访时间为8~24个月(平均18.5个月),21例失访,未见疝复发及术侧睾丸发育异常。结论在腹腔镜下运用自制双孔缝合针对小儿疝囊进行高位结扎具有手术时间短、局部创伤小、术后并发症少、术后疼痛轻、操作简单等优点,在临床上具有推广价值。
目的 探讨应用改良Kugel补片后入路腹膜前修补腹股沟斜疝的优点、手术效果及其体会。方法 回顾性分析2006年12月至2007年6月期间我院采用改良Kugel补片施行腹股沟斜疝无张力修补术15例患者的临床资料。观察手术时间、伤口疼痛、术后恢复情况、并发症和复发率。结果 手术时间35~90 min,平均(50±10) min; 术后1 d能下床活动,术后均未使用止痛剂,术后住院时间3~5 d。全组切口一期愈合,无感染发生,1例切口周围有青紫,微波治疗1周后青紫消失。随访半年无不适和复发。结论 改良Kugel补片后入路腹膜前疝修补术具有微创、无张力、免缝合、疼痛轻、恢复快、并发症少等特点
Objective To investigate the clinical value of laparoscopic high ligation of hernia sac with constructed veress needle in the treatment of indirect inguinal hernia in children. Methods Ninety-one cases of pediatric indirect inguinal hernia who received treatment in Suqian People’s Hospital of Nanjing Drum-Tower Hospital Group from October 2014 to December 2015 were selected and randomly divided into two groups, cases of laparoscopy group (n=41) were treated by laparoscopic high ligation of hernia sac with constructed veress needle, and cases of tradition group (n=50) were treated with traditional open high ligation of hernia sac. Comparison of clinical effect between the 2 groups was performed. Results All the operations were successfully carried out, and there was no conversion to open surgery in laparoscopy group. Three cases were diagnosed as two-side inguinal hernia in laparoscopy group, who were diagnosed as one-side inguinal hernia before operation. The operation time, length of surgical incision, blood loss, and hospital stay of the laparoscopy group were all significantly less than those of the tradition group (P<0.05). The incidence of postoperative complications such as scrotal edema and scrotal hydrocele, incidence of testicular dysplasia, and the recurrence rate in the laparoscopy group were all significantly lower than those of the tradition group (P<0.05). Conclusions Laparoscopic high ligation of hernia sac with constructed veress needle in the treatment of indirect inguinal hernia in children has good application value, which has advantages of small surgical trauma, shorter hospital stay, faster recovery, and less postope-rative complications, and we can find out contralateral recessive hernia during operation and avoid the second surgery.