目的 比较外环口修补术(实验组)、非外环口修补术(对照组)和其他不符合较大潜在复发风险的腹股沟斜疝患儿(普通组)手术后复发率,探讨外环口修补术对腹股沟斜疝术后复发率的影响。 方法 回顾性分析2014年1月至2015年6月本院收治的2 026例年龄小于4岁的腹股沟斜疝患儿临床资料,其中经评估具有较大复发风险的患儿620例,对其中316例行小横切口下疝囊高位结扎联合外环口修补术(实验组),304例行单纯疝囊高位结扎术(对照组),其余1 406例行疝囊高位结扎术(普通组)。比较三组患儿手术时间、术后发热、血肿、伤口感染的发生情况及斜疝复发率。 结果 三组在性别、年龄、术后发热、血肿、伤口感染等并发症上比较,差异无统计学意义(P>0.05)。手术时间比较差异有显著统计学意义(F=196.98,P<0.001),经两两比较发现对照组与普通组无差异(P=0.062),而实验组手术时间较对照组及普通组长(P<0.05)。在术后复发率方面,实验组、对照组和普通组分别为0.00%、 5.00%和0.91%,经统计学分析差异有意义(χ2=42.18,P<0.001),进一步进行两两比较发现实验组与普通组复发率无差异(χ2=3.41,P=0.065),而对照组复发率高于实验组(χ2=19.02,P<0.001)与普通组(χ2=30.44,P<0.001)。 结论 外环口修补术能显著降低部分腹股沟斜疝患儿的术后复发率,值得临床推广。
Objective To explore the effects of external ring repair on recurrent rate of inguinal hernia. Methods From January 2014 to June 2015, retrospective analysis was performed for 2026 patients aged under 4 years with oblique hernia. Among 620 children with a higher risk of recurrence, high-ligation of hernia sac plus outer ring mouth repair under small transverse incision(experimental group, n=316), simple high-ligation of hernia sac(control group, n=304)and high-ligation of hernia sac(normal group, n=1406)were performed. The inter-group differences were statistically analyzed. Results No differences existed in gender, age, postoperative fever, hematoma and wound infection complications among three groups. The operative duration of experimental group was longer than those of control and normal groups. The recurrent rates of experimental, control and normal groups were 0.00%, 5.00% and 0.91% respectively. No difference existed between experimental and normal groups. And control group was higher than experimental and normal groups. Conclusion Outer ring repair can significantly reduce the recurrent rate of pediatric inguinal hernia. It is worthy of clinical popularization.
