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当前位置: 代写毕业论文 >> 临床医学 >> 特制钩式雪橇针行腹腔镜下疝囊高位结扎术48例的体会

特制钩式雪橇针行腹腔镜下疝囊高位结扎术48例的体会

来源:华世论文网
 

         作者:刘焕军 安郁利 李贺 尹高平 宋协瑶

【摘要】目的:探讨微创治疗小儿斜疝及交通性鞘膜积液的新方法。方法:对李宇洲、曲金龙的手术方法加以改进,经脐上缘和脐左侧3cm处分别置腹腔镜和组织钳,于内环口腹壁的体表投影处作0.2cm皮肤切口,用特制的钩式雪橇针带双股丝线入腹腔内环口腹膜外,一次进针,双侧穿插,内环口两侧分别穿插,完成内环口高位双重结扎,用时5~10min,整个用时10~30min。结果:全部手术均获成功,术后当天患儿即可进食,术后6~8h下床,第3天痊愈出院,无手术并发症。结论:此法与“套线法”具有相同的临床效果,可用于治疗小儿斜疝及交通鞘膜积液。

    【关键词】疝腹股沟;鞘膜积液;儿童;腹腔镜
【Abstract】Objective:To study a new microinvasive technique for indirect hernia and communicating hydrocele in chidren.Methods: The surgical procedures were modified according to the Li Yuzhou’s and Qu Jinlong’s.In operation,laparoscope and tissue forceps were set aside 3cm off the superior border and medial umbilicus,a 0.2cmincision was made at the projective landmark of endocyclic abdominal wall,which was pierced across the two sides with a self made fishhook kirschner pins.The high ligation of endocyclic incision was completely in 510 minutes,and the total surgery was finished in 1030 minutes.Results:All the surgeries were successfully done.The patients could be out of bed in 68 hours and were discharged from hospital on the 3rd day after recovery without complication.Conclusions:This method is similar with Qu’s in clinic effect for oblique hernia and communicating hydrocele in children.

    【Key words】Hernia,inguinal;Hydrocele;Child;Laparoscopy

    2002年7月至2004年12月我院应用自制钩式雪橇针行腹腔镜下腹股沟斜疝及交通性鞘膜积液等52例次疝囊高位结扎术,疗效满意,现报道如下。

    1资料与方法

    1.1临床资料本组48例均为男性,单纯右侧29例,单纯左侧15例,双侧4例,1~12岁42例,13~18岁6例,平均6.9岁,其中术中探查见对侧腹股沟管未闭4例。

    1.2手术方法

    1.2.1自制雪橇针结构将直径2.0mm克氏针针头磨成钝锐相结合的扁平宝剑头形,针头端钻有穿线孔,穿线孔呈长椭圆型,一侧有开放的侧口,7号线能顺利通过此侧口进入穿线孔,针孔位于雪橇针头端3~6mm处,针长15~20cm,针(侧面)呈“雪橇”状,故名“雪橇针”;备灭菌后的输液瓶胶塞1枚,剪开后由带7号丝线的雪橇针贯穿胶塞,固定丝线于雪橇针上备用;弯曲后的针头长约8mm,将雪橇针杆弯成160°~165°。

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