Objective:To investigate the efficacy and safety of single-port laparoscopic high ligation of the hernia sac in the treatment of pediatric inguinal hernia.Methods:94 cases children with pediatric hernia in our hospital were selected and divided into experimental group and control group according to the different surgeries, each group for 47 cases. The experimental group received incision laparoscopic high ligation of the hernia sac, while the control group received open high surgery of the hernia sac. The clinical efficacy of the 2 groups was compared, and the time of operation, hospitalization time, time to get out of bed, the amount of bleeding during surgery and the incidence of postoperative complications of the 2 groups were statisticsed.Results:The total effective rate in the experimental group was 95.74%, which was significantly higher than that in the control group (85.11%) (P<0.05); the time of operation, hospitalization time, and time to get out of bed in the experimental group were significantly shorter than those in the control group, the amount of bleeding during surgery in the experimental group was less than that in the control group (P<0.05); the incidence of complications such as scrotal edema and secondary hydrocele in the experimental group was lower than that of the control group (P<0.05).Conclusion:Single-port laparoscopic high ligation of hernia sac in the treatment of pediatric hernia can significantly relieve clinical symptoms, improve surgical indicators of patients and effectively control postoperative complications, which is worthy of clinical promotion.

目的 探讨无插管全麻下超小切口不缝合治疗小儿腹股沟斜疝的临床效果.方法 选取我院2018年6月至2019年5月收治的腹股沟斜疝患儿60例作为对照组,选取我院2019年6月至2020年6月收治的腹股沟斜疝患儿60例作为对研究组.比较两组的临床疗效、围术期指标、术后并发症情况.结果 研究组治疗总有效率为96.67％,高于对照组的85.00％(P<0.05).研究组切口长度、术中出血量、术后清醒时间、术后进食时间及住院时间均优于对照组(P<0.05).研究组术后并发症发生率为3.33％,低于对照组的13.33％(P<0.05).结论 无插管全麻下超小切口不缝合治疗小儿腹股沟斜疝的效果满意且安全性高.

目的 探讨腹腔血与静脉血HCG比值(RPHCG/VHCG)诊断异位妊娠的临床价值.方法 回顾性分析我院2019年6月至2020年7月收治的50例异位妊娠腹腔内出血患者的临床资料,进行HCG定性、定量检测,分析RPHCG/VHCG诊断异位妊娠的临床价值.结果 腹腔血β-HCG定量检测值显著高于静脉血(P<0.05),RPHCG/VHCG为2.5.RPHCG/VHCG>1诊断异位妊娠的敏感度与特异度分别为97.78％、100.00％.结论 RPHCG/VHCG诊断异位妊娠具有较高的临床价值.

目的 分析青少年原发性自发性气胸( PSP)患者胸腔镜术后复发的危险因素,为PSP术后预防复发提供依据.方法 纳入对象为2010年11月至2016年1月北京友谊医院平谷医院胸外科收治的236例PSP患者,随访24个月,记录术后复发情况.将复发患者设为观察组,未复发患者设为对照组,收集所有患者病历资料,探讨性别、年龄、住院时间等对PSP复发的影响,并通过单因素与logistic回归分析探讨PSP患者胸腔镜术后复发的独立危险因素.结果 236例患者术后24个月内复发28例,复发率11. 86% ,左侧16例,右侧12例,复发时间为(8. 56 ± 2. 12)个月,复发年龄(24. 34 ± 3. 54)岁. 2组患者身体质量指数(BMI)、胸膜固定术、性别、术后吸烟、术前PSP发作次数、术后漏气时间、胸管维持时间对患者术后复发的影响差异具有统计学意义(P＜0. 05);而年龄、发病部位、住院时间、手术时间、胸膜固定方法对患者术后复发的影响差异无统计学意义(P＞0. 05).多因素logistic回归分析结果显示术前PSP发作次数大于等于3次(OR=2. 543,95% CI:0. 765～6. 646)、术后吸烟( OR=2. 764,95% CI:1. 032～7. 521)、BMI＜18. 5 kg/m2 (OR=2. 214,95% CI:1. 211～9. 623)、未进行胸膜固定术( OR=2. 486,95% CI:1. 186～7. 326)是PSP患者胸腔镜术后复发的独立危险因素.结论 PSP发作次数大于等于3次、术后吸烟、BMI＜18. 5 kg/m2 、未进行胸膜固定术均会增加PSP患者胸腔镜术后复发风险.