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目的探讨下腹部正中横形小切口在治疗小儿腹股沟疝中的临床应用价值。方法 150例腹股沟疝患儿,根据手术方式分为两组。实验组:下腹正中(耻骨联合上方皮纹处)横形小切口75例,仅行单侧处理55例,行双侧处理20例(包括术前诊断为双侧腹股沟疝14例,术前诊断为单侧腹股沟疝,术中探查对侧6例);对照组:患侧下腹横纹切口75例,单侧56例(不进行对侧探查),双侧19例。对两组手术时间、切口长度、术中出血量、术后切口美观程度、术后复发率、平均住院费用等方面进行比较。结果实验组仅处理单侧与对照组行单侧手术在手术时间、切口长度、术中出血量、术后切口美观程度、住院平均费用等方面比较差异无统计学意义(P>0.05)。实验组处理双侧与对照组行双侧手术在手术时间、切口长度、术中出血量、术后切口美观程度、住院平均费用等方面比较,实验组明显优于对照组,差异有统计学意义(P<0.05)。结论下腹部正中横形小切口在治疗小儿双侧腹股沟疝中具有手术时间短、术中出血少、术后切口更美观、术后复发率更低、平均住院费用更少等多方面优点,尤其是对于对侧隐匿性疝或对侧是否存在腹股沟疝不确定时,其对侧可探查功能是目前除腹腔镜手术方式以外其他手术方式不可替代的,值得临床推广。
Objective To investigate the clinical value of transverse incision in the lower abdomen for the treatment of children with inguinal hernia. Methods 150 cases of inguinal hernia in children, divided into two groups according to surgical methods. In the experimental group, there were 75 small transverse incisions in the middle of the lower abdomen (the upper pubic symphysis), only 55 cases of unilateral treatment and 20 cases bilateral treatment (including 14 cases of bilateral inguinal hernias diagnosed preoperatively Unilateral inguinal hernia, intraoperative exploration contralateral 6 cases); control group: ipsilateral lower abdomen transverse incision in 75 cases, unilateral 56 cases (without contralateral exploration), bilateral in 19 cases. The operation time, incision length, intraoperative blood loss, postoperative aesthetic appearance, postoperative recurrence rate and average hospitalization cost were compared between the two groups. Results There was no significant difference in the operation time, incision length, intraoperative blood loss, postoperative aesthetic appearance and average cost of hospitalization between experimental group and unilateral control group (P> 0.05). The experimental group was significantly better than the control group in bilateral surgery compared with the control group in the operation time, incision length, blood loss, the degree of postoperative aesthetic appearance, the average cost of hospitalization, etc. The difference was statistically significant (P <0.05). Conclusion The middle transverse incision in the lower abdomen has many advantages such as shorter operation time, less intraoperative bleeding, more beautiful postoperative incision, lower postoperative recurrence rate and less average hospitalization cost, especially in the treatment of bilateral bilateral inguinal hernia Contralateral occult hernia or on the contralateral side of the inguinal hernia is uncertain, its contralateral probing function is currently available in addition to other laparoscopic surgical methods irreplaceable, is worthy of clinical promotion.