微创医学

目的评价腹腔镜小儿腹股沟疝修补术在日间手术模式下的安全性及其对儿童、家庭的影响。方法将200例腹股沟疝患儿随机分成A，B两组，A组100例采用日间手术模式，B组100例采用常规入院模式。A、B组均行腹腔镜疝囊高位结扎术。结果两组均随访1～2年，A组平均手术时间为15 min，术后6个月复发1例；B组平均手术时间16 min，术后1年复发1例。A组与B组手术平均时间及复发率比较，差异无统计学意义。 A组术后伤口出血2例，阴囊血肿1例；B组trocar脐孔疝1例需再次手术，线结反应2例。A组平均住院时间12 h，B组平均住院3.3 d（P＜0.05）。A组人均住院费5 856.1元；B组人均住院费6 112.3元。两组平均住院时间、人均住院费比较，差异有统计学意义（P＜0.05）。结论开展日间模式腹腔镜小儿腹股沟疝修补术安全，患者可接受，可以最大限度降低费用，减少住院时间及家属住院陪护时间，有助于提高科室床位周转率和使用率，充分利用医疗资源。

ObjectiveTo assess the efficacy and safety of daytime laparoscopic inguinal hernia repair in children and its benefits to the child and family. Methods200 children with inguinal hernia were randomly divided into two groups.Group A(100 cases) were admitted to the Day case. Group B (100 cases) underwent regular hospitalization. All the patients underwent laparoscopic hernioplasty. ResultsDuring the follow-up of 1-2years, the average of operation time was 15min in Group A while 16min in Group B. 1case experienced recurrence 6 months after operation in Group A, and one relapsed after 1 year in Group B. The operation time and the recurrence showed no significant difference. The complications occurred in 3 cases in group A(two suffered from wound hemorrage, one suffered from scrotal hematoma), and 3 cases suffered from complications in group B(one umbilical hernia, tow infection).The mean hospitalization time was 12 hours in group A while 3.3 days in group B(P＜0.05). The mean cost was 5856.1 RMB in group A and 6112.3RMB in group B(P＜0.05). ConclusionsDaytime laparoscopic hernia repair in children is a safe and well accepted by patients and parents. It can not only decrease the cost, hospitalization time and the parents′ time in hospital, but also improve department turnover and the utilization of beds, and save enormous health care resources effectively.