中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2015年
5期
448-450
,共3页
小儿隐睾%腹腔镜手术%开放式手术
小兒隱睪%腹腔鏡手術%開放式手術
소인은고%복강경수술%개방식수술
Children with cryptorchidism%The traditional open surgery%Laparoscopic surgery
目的 探讨传统开放手术与腹腔镜手术治疗小儿隐睾的临床效果.方法 将60例隐睾患儿应用随机数字表分为两组,采用开放式手术30例,采用腹腔镜手术30例,比较两组患儿的手术时间、术中出血量、术后下床时间、术后住院时间,评价疗效和并发症情况.结果 腹腔镜组单侧隐睾23例,双侧隐睾7例,术中出血量分别为(3.2±0.5)、(5.1±1.4) ml,手术时间分别为(41.1±6.3)、(67.3±5.6) min;开放手术组单侧隐睾24例,双侧隐睾6例,术中出血量和手术时间分别为(13.4±1.8)、(17.7±2.1)ml,(56.1±5.7)、(81.2±8.9) min,组间比较差异均有统计学意义(t值分别为29.91、27.34、9.67、7.24,P均＜0.05);术后恢复情况,腹腔镜组术后下床活动时间、术后住院时间分别为(2.7±0.6)、(4.3±0.9)d,均显著低于开放手术组[(5.8±0.7)、(8.1±0.5)d],差异均有统计学意义(t值分别为18.42、20.22,P均＜0.05).术后随访两组患儿的伤口愈合均较好,开放手术组4例患儿术后B超显示血运较差,睾丸位于阴囊中部以上,无弹性;观察组患儿术后B超检查正常,睾丸位于阴囊底部,有弹性,腹腔镜组疗效优于开放手术组(x2=2.41,P＜0.05).开放手术组3例出现手术感染,降入阴囊睾丸回缩1例,萎缩2例,需要二次手术,腹腔镜组患者无并发症发生,差异有统计学意义(P＜0.05).结论 腹腔镜较传统开放式手术治疗小儿隐睾具有切口小、疗效好、术后恢复快以及并发症少等优点,值得广泛推广使用.
目的 探討傳統開放手術與腹腔鏡手術治療小兒隱睪的臨床效果.方法 將60例隱睪患兒應用隨機數字錶分為兩組,採用開放式手術30例,採用腹腔鏡手術30例,比較兩組患兒的手術時間、術中齣血量、術後下床時間、術後住院時間,評價療效和併髮癥情況.結果 腹腔鏡組單側隱睪23例,雙側隱睪7例,術中齣血量分彆為(3.2±0.5)、(5.1±1.4) ml,手術時間分彆為(41.1±6.3)、(67.3±5.6) min;開放手術組單側隱睪24例,雙側隱睪6例,術中齣血量和手術時間分彆為(13.4±1.8)、(17.7±2.1)ml,(56.1±5.7)、(81.2±8.9) min,組間比較差異均有統計學意義(t值分彆為29.91、27.34、9.67、7.24,P均＜0.05);術後恢複情況,腹腔鏡組術後下床活動時間、術後住院時間分彆為(2.7±0.6)、(4.3±0.9)d,均顯著低于開放手術組[(5.8±0.7)、(8.1±0.5)d],差異均有統計學意義(t值分彆為18.42、20.22,P均＜0.05).術後隨訪兩組患兒的傷口愈閤均較好,開放手術組4例患兒術後B超顯示血運較差,睪汍位于陰囊中部以上,無彈性;觀察組患兒術後B超檢查正常,睪汍位于陰囊底部,有彈性,腹腔鏡組療效優于開放手術組(x2=2.41,P＜0.05).開放手術組3例齣現手術感染,降入陰囊睪汍迴縮1例,萎縮2例,需要二次手術,腹腔鏡組患者無併髮癥髮生,差異有統計學意義(P＜0.05).結論 腹腔鏡較傳統開放式手術治療小兒隱睪具有切口小、療效好、術後恢複快以及併髮癥少等優點,值得廣汎推廣使用.
목적 탐토전통개방수술여복강경수술치료소인은고적림상효과.방법 장60례은고환인응용수궤수자표분위량조,채용개방식수술30례,채용복강경수술30례,비교량조환인적수술시간、술중출혈량、술후하상시간、술후주원시간,평개료효화병발증정황.결과 복강경조단측은고23례,쌍측은고7례,술중출혈량분별위(3.2±0.5)、(5.1±1.4) ml,수술시간분별위(41.1±6.3)、(67.3±5.6) min;개방수술조단측은고24례,쌍측은고6례,술중출혈량화수술시간분별위(13.4±1.8)、(17.7±2.1)ml,(56.1±5.7)、(81.2±8.9) min,조간비교차이균유통계학의의(t치분별위29.91、27.34、9.67、7.24,P균＜0.05);술후회복정황,복강경조술후하상활동시간、술후주원시간분별위(2.7±0.6)、(4.3±0.9)d,균현저저우개방수술조[(5.8±0.7)、(8.1±0.5)d],차이균유통계학의의(t치분별위18.42、20.22,P균＜0.05).술후수방량조환인적상구유합균교호,개방수술조4례환인술후B초현시혈운교차,고환위우음낭중부이상,무탄성;관찰조환인술후B초검사정상,고환위우음낭저부,유탄성,복강경조료효우우개방수술조(x2=2.41,P＜0.05).개방수술조3례출현수술감염,강입음낭고환회축1례,위축2례,수요이차수술,복강경조환자무병발증발생,차이유통계학의의(P＜0.05).결론 복강경교전통개방식수술치료소인은고구유절구소、료효호、술후회복쾌이급병발증소등우점,치득엄범추엄사용.
Objective To investigate curative effect of traditional open surgery and laparoscopic surgery on pediatric patients with cryptorchidism.Methods Sixty cases with cryptorchidism were randomly divided into two groups.Thirty cases in the control group were with open surgery,and 30 cases were given laparoscopic surgery and served as laparoscopic group.Operation time,blood loss,bed time,postoperative hospital stay,evaluating curative effect and complications were recorded.Results Twenty-three cases were unilateral cryptorchidism and 7 cases were bilateral cryptorchidism in laparoscopic group.The blood loss and operating time of patients with unilateral and bilateral cryptorchidism in laparoscopic group were (3.2± 0.5),(5.1 ± 1.4) ml,and (41.1 ± 6.3),(67.3 ± 5.6) min.In the control group,24 cases were with unilateral cryptorchidism,6 patients with bilateral cryptorchidism.The blood loss and operating time of patients with unilateral and bilateral cryptorchidism in control group were (13.4± 1.8) and (17.7 ± 2.1) ml,(56.1 ± 5.7) and (81.2 ± 8.9) min.The differences between groups were statistically significant (t =29.91,27.34,9.67,7.24;P＜ 0.05).The stay bed time and postoperative hospital time in observation group were (2.7±0.6),(4.3±0.9)d,significantly lower than those of the control group ((5.8 ± 0.7),(8.1 ± 0.5) d),and the differences were statistically significant(t =18.42,20.22;P＜0.05).Wound healing in two groups were better during follow-up periods,after operation,B ultrasound showed that 4 cases of poor blood supply,and located in the scrotum testis above middle,inelasti in control group,while there were without abnormal in observation grtoup with scrotal testis at bottom and elastic.The curative effect of observation group was better than that of control group (x2 =2.41,P＜0.05).Three cases of observation group occurred surgical infection.One case was scrotal testes retraction and 2 cases with atrophy,which needed a second operation.The complications occurred number of observation group was significant different from that in control groups(P＜0.05).Conclusion The laparoscopic is with small incision,good curative effect,quick recovery and less complications,and children with less pain,shorter hospitalization time,low cost than traditional open surgery treatment of children with cryptorchidism,which is worth popularizing widely used.
