日间手术模式下腹腔镜下小儿鞘状突高位结扎术的临床效果分析

Clinical Effect Analysis of Laparoscopic High Ligation of the Processus Vaginalis in Pediatric Patients under the Ambulatory Surgery Mode

摘要: 目的：探究日间手术模式下腹腔镜下小儿鞘状突高位结扎术治疗小儿鞘膜积液的临床应用效果。方法：回顾性分析2022年6月至2024年6月本院诊治的95例鞘膜积液患儿资料，按手术方式分为观察组(50例，腹腔镜下鞘状突高位结扎术)与对照组(45例，开放式手术高位结扎术)，对比两组围术期相关指标、术后并发症及复发率。结果：观察组手术时间、术中出血量、切口长度及术后12 h疼痛评分均显著优于对照组(P < 0.05)，但住院费用高于对照组(P < 0.05)；两组术后肠功能恢复时间、并发症发生率(观察组8.0% vs对照组13.3%)及复发率(观察组2.0% vs对照组0%)无统计学差异(P > 0.05)。结论：日间手术模式下腹腔镜下小儿鞘状突高位结扎术治疗小儿鞘膜积液创伤小、疼痛轻、效果显著，虽费用较高，但符合儿童生理特点与医疗服务优化需求，具有临床推广价值。

Abstract: Objective: To explore the clinical effect of laparoscopic high ligation of the processus vaginalis for pediatric hydrocele under the ambulatory surgery mode. Methods: A retrospective analysis was conducted on the data of 95 children with hydrocele treated in our hospital from June 2022 to June 2024. They were divided into an observation group (50 cases, laparoscopic high ligation of the processus vaginalis) and a control group (45 cases, open high ligation of the processus vaginalis) according to the surgical method. Perioperative-related indicators, postoperative complications and recurrence rate were compared between the two groups. Results: The operation time, intraoperative blood loss, incision length and postoperative 12 h pain score in the observation group were significantly better than those in the control group (P < 0.05), but the hospitalization cost was higher than that in the control group (P < 0.05). There were no statistically significant differences in postoperative intestinal function recovery time, complication rate (8.0% in the observation group vs 13.3% in the control group) and recurrence rate (2.0% in the observation group vs 0% in the control group) between the two groups (P > 0.05). Conclusion: Laparoscopic high ligation of the processus vaginalis for pediatric hydrocele under the ambulatory surgery mode has the advantages of minimal trauma, mild postoperative pain and significant effect. Although the cost is higher, it is in line with the physiological characteristics of children and the needs of medical service optimization, and has clinical promotion value.