杨周健　刘钧　杨健

[摘要] 目的 研究单孔腹腔镜疝气针（SPLHN）治疗小儿腹股沟斜疝（IIHC）的临床效果及安全性。 方法 选择2016年9月～2017年9月在绵阳市中心医院接受手术治疗的160例IIHC患儿进行研究。将患儿按随机数字表法分成观察组以及对照组，每组各80例。观察组患儿予以SPLHN术式治疗，对照组患儿予以传统的两孔法腹腔镜术式治疗。對比两组疗效指标、术后安全性以及C反应蛋白（CRP）和白细胞介素-10（IL-10）水平。 结果 两组的手术时间、出血量、住院时间和住院费用比较，差异无统计学意义（P > 0.05）。两组术后并发症的总发生率比较，差异无统计学意义（P > 0.05）。两组术后7 d的CRP和IL-10水平均明显高于术前，但观察组低于对照组，差异有高度统计学意义（P < 0.01）。 结论 对IIHC患儿给予SPLHN术式治疗的效果较好，安全性较高，造成的炎症影响较小，值得在临床上推广。

[关键词] 单孔腹腔镜疝气针；小儿腹股沟斜疝；临床疗效；安全性；C反应蛋白；白细胞介素-10

[中图分类号] R726.1 [文献标识码] A [文章编号] 1673-7210（2018）07（b）-0108-04

[Abstract] Objective To study the clinical efficacy and safety of single-port laparoscopic hernia needle （SPLHN） in the treatment of indirect inguinal hernia in children （IIHC）. Methods 160 children with IIHC who was given surgical treatment from September 2016 to September 2017 in Mianyang Central Hospital were studied. The children were divided into observation group （n = 80） and control group （n = 80） according to random number table. The children in the observation group were treated by SPLHN， while the children in the control group were treated by traditional two-hole laparoscopic surgery. The efficacy， postoperative safety， recurrence and levels of C-reactive protein （CRP） and interleukin-10 （IL-10） were compared between the two groups. Results There was no significant difference in operation time， bleeding volume， hospitalization time and hospitalization cost between the two groups （P > 0.05）. And there was no significant difference in the total incidence of postoperative complications between the two groups （P > 0.05）.The levels of CRP and IL-10 in both groups at 7 days after operation were significantly higher than those before operation， but the observation group was lower than the control group， with statistically significant difference （P < 0.01）. Conclusion SPLHN treatment for IIHC is more effective， safer and less inflammatory， which is worthy of clinical application.

[Key words] Single-port laparoscopic hernia needle； Indirect inguinal hernia in children； Clinical efficacy； Safety； C-reactive protein； Interleukin-10

小儿腹股沟斜疝（indirect inguinal hernia in children，IIHC）是一种儿科常见疾病，其发病率较高，以男性患儿为主。据统计，此病的男女比例大约是15∶1，且以右侧多见，病因主要是先天性的鞘状突未闭[1]。关于IIHC的治疗，手术疗效较好，且通常在手术中仅需实施疝囊高位结扎即可产生确切疗效[2]。当前腹腔镜手术方案已被广泛地应用于治疗IIHC患儿，并已被广大的临床医务工作者以及患儿的家长所认可。虽然临床使用的传统两孔腹腔镜术式虽然也可获得较好的疗效，但由于微创理念在手术过程中的发展，单孔腹腔镜疝气针（single-port laparoscopic hernia needle，SPLHN）辅助手术由于仅需单孔操作，不仅满足微创需求，减轻患者创伤，而且术后几乎无瘢痕[3-4]。白细……