[1]赵易丹,沈桢,宋再,等. 儿童腹股沟斜疝修补术后线结反应的危险因素分析[J].临床小儿外科杂志,2019,18(01):49-53.
　Zhao Yidan,Shen Zhen,Song Zai,et al. Analyzing risk factors of suture reaction after repairing pediatric indirect hernia.[J].Journal of Clinical Pediatric Surgery,2019,18(01):49-53.
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 儿童腹股沟斜疝修补术后线结反应的危险因素分析

《临床小儿外科杂志》[ISSN:1671-6353/CN:43-1380/R] 卷: 第18卷 期数: 2019年01期 页码: 49-53 栏目: 论著 出版日期: 2019-01-20
Title:
 Analyzing risk factors of suture reaction after repairing pediatric indirect hernia.
作者:
 赵易丹; 沈桢; 宋再; 等
 枣庄市妇幼保健院儿外科
Author(s):
 Zhao Yidan; Shen Zhen; Song Zai; Sun Song; Chen Gong; Zheng Shan.
 Department of Pediatric Surgery,Municipal Maternity & Child Healthcare Center,Zaozhuang 277100,China
关键词:
 ; 儿童;  腹腔镜;  疝; 腹股沟;  再手术;  危险因素
Keywords:
 ; Child;  Laparoscopes;  Hernia; Inguinal;  Reoperation;  Risk Factors
文献标志码:
A
摘要:
 目的调查小儿腹股沟斜疝术后线结反应的发生率,并分析其危险因素。方法以2015年7月至2016年6月于枣庄市妇幼保健院儿外科接受手术治疗的1 307例腹股沟斜疝患儿为研究对象，按照手术方式的不同分为开放组及腹腔镜组，所有患儿随访至少10个月。回顾性分析发生线结反应患儿的人口学资料、临床表现、过敏史、手术时间、反应侧别情况，采用χ2检验对影响线结反应发生的因素进行分析。结果腹腔镜组和开放组的线结反应发生率分别为2.43%和0.82%，两组间无统计学差异（P=0.052）。腹腔镜术后线结反应具体表现包括：皮下结节（11例）、脓肿（7例）、皮肤瘘（4例）。其中术后1个月内发生9例（45%）， 术后1~6个月内发生9例（45%），术后6个月以后发生2例（10%）。应用丝线及Prolene线的患儿线结反应的发生率无统计学差异（P=0.633）。双侧斜疝患儿的线结反应发生率高于单侧斜疝患儿（P=0.011）。行双侧腹腔镜斜疝修补术患儿术后发生线结反应的侧别中，左侧占42.86%（6/14），右侧占42.86%（6/14），双侧占14.29%（2/14）。3例（2例左侧，1例右侧）经取出缝线后痊愈，2例(均为右侧)复发。结论线结反应是腹腔镜腹股沟斜疝术后的重要并发症之一，术后1个月内线结反应发生率较高。双侧斜疝可能是造成腹腔镜腹股沟斜疝术后线结反应发生的高危因素之一。
Abstract:
 ObjectiveTo explore the incidence and risk factors of suture reaction after repairing pediatric inguinal hernia.MethodsFrom July 2015 to June 2016,the clinical data were analyzed retrospectively for 1307 hospitalized cases of inguinal hernia undergoing open herniotomy and laparoscopic hernia repair.The relevant data included demographic profiles,clinical manifestations,allergy history,operative duration and sideness of suture reaction.Followups were conducted for at least 10 months.ResultsThe incidence rate of suture reaction were 2.43% and 0.82% during laparoscopy and open surgery (P=0.052).The clinical manifestations of suture reaction after laparoscopy were subcutaneous nodules (n=11),abscess (n=7) and fistula (n=4).Occurring time was 1 month (n=9.45%),1-6 months (n=9,45%) and after 6 months (n=2,10%).During laparoscopy,the incidence rate of suture reaction using silk line was higher than that using Prolene line (P=0.633).Bilateral hernia reaction rate was higher than that of unilateral hernia (P=0.011).During bilateral hernia surgery,sideness was left (42.86%,6/14),right (42.86%,6/14) and bilateral (14.29%,2/14).Among them,3 curative cases (2 left,1 right) occurred after removing stitches and 2 rightside cases were recurrent.ConclusionSuture reaction is an important complication after laparoscopic repair of pediatric indirect hernia.This condition is common within 1 month postoperation.Bilateral hernia may be a highrisk factor of suture reaction after laparoscopic hernia repair.

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更新日期/Last Update: 2019-01-22