切换至 "中华医学电子期刊资源库"

中华腔镜泌尿外科杂志(电子版) ›› 2025, Vol. 19 ›› Issue (01) : 36 -40. doi: 10.3877/cma.j.issn.1674-3253.2025.01.007

临床研究

日间手术在儿童鞘膜积液腹腔镜手术中的应用
刘志新1,(), 陈小林1, 肖文军1, 刘思琪1   
  1. 1.412008 湖南,株洲市妇幼保健院小儿外科
  • 收稿日期:2023-03-09 出版日期:2025-02-01
  • 通信作者: 刘志新

Application of day surgery mode in laparoscopy for hydrocele in children

Zhixin Liu1,(), Xiaolin Cheng1, Wenjun Xiao1, Siqi Liu1   

  1. 1.Department of Pediatric Surgery, Women and Children Hospital of Zhuzhou, Hunan 412008, China
  • Received:2023-03-09 Published:2025-02-01
  • Corresponding author: Zhixin Liu
引用本文:

刘志新, 陈小林, 肖文军, 刘思琪. 日间手术在儿童鞘膜积液腹腔镜手术中的应用[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2025, 19(01): 36-40.

Zhixin Liu, Xiaolin Cheng, Wenjun Xiao, Siqi Liu. Application of day surgery mode in laparoscopy for hydrocele in children[J/OL]. Chinese Journal of Endourology(Electronic Edition), 2025, 19(01): 36-40.

目的

探讨日间手术模式在儿童鞘膜积液腹腔镜手术中的应用。

方法

将2020年1月至2022年3月在株洲市妇幼保健院小儿外科应用腹腔镜技术治疗儿童鞘膜积液的患儿进行分组,日间手术模式下完成手术的鞘膜积液患儿57例,为日间手术组,普通住院流程下完成手术的鞘膜积液患儿54例为对照组,比较两组患儿平均住院时间、平均住院费用以及家属满意度等指标。

结果

两组病例均顺利完成手术,术前单侧鞘膜积液患儿107例,发现对侧鞘状突未闭(CPPV)33例,发生率30.84%,其发生率与左右侧间的差异无统计学意义;双侧鞘膜积液4例。日间手术组平均住院日为(1.7±0.7)d,平均住院费用为(5978±584)元,均明显低于对照组(3.8±0.6)d、(6362±771)元,差异具有统计学意义(P<0.05)。日间手术组患儿家属满意度(96.49%)明显优于对照组(92.59%),差异具有统计学意义(P<0.05)。

结论

日间手术模式在儿童鞘膜积液腹腔镜手术中的应用明显缩短了患儿住院时间,降低了住院费用,提高了患儿家属满意度。

Objective

To explore the application of day surgery mode in laparoscopy for hydrocele in children.

Methods

The clinical data in 57 cases of child hydrocele (day surgery group)surgically treated by the daytime laparoscopic surgery of Women and Children Hospital of Zhuzhou from January 2020 to March 2022 were analyzed, and compared with 54 cases with hydrocele treated by the general laparoscopic procedure(control group).

Results

33 cases (30.84%) with contralateral patent processus vaginalis (CPPV) were observed among 107 cases with unilateral hydrocele,the prevalence of CPPV was not statistically different between different initial sides. There were 4 cases with bilateral hydrocele. The indexes included:length of stay (1.7±0.7) d, the cost (5978±584) yuan, and the satisfaction of family members (96.49%) in the day surgery group, which were better than that in the control group,and the difference was statistically significant (P<0.05).

Conclusion

The application of day surgery mode in laparoscopy for hydrocele in children significantly shortened the hospital stay, reduced the hospital cost, and improved the satisfaction of children's family members.

表1 两组鞘膜积液患儿一般资料比较
表2 两组患儿住院时间、住院费用及满意度比较
[1]
余中景, 林镇营, 李焕源, 等. 经脐单孔1.1毫米腹腔镜手术治疗小儿鞘膜积液及腹股沟斜疝的对比研究[J]. 临床小儿外科杂志,2024, 23(6): 584-588.Yu ZJ, Lin ZY, Li HY, et al. Clinical efficacies of 1.1 mm endoscopic technique for hydrocele and inguinal hernia in children[J]. J Clin Pediatr Surg, 2024, 23(6): 584-588.
[2]
常建国, 杨宇, 张成, 等. 腹腔镜下鞘突高位结扎术与小切口高位结扎术治疗小儿鞘膜积液、疝的疗效及安全性比较[J]. 临床和实验医学杂志, 2024, 23(20): 2196-2200.Chang JG, Yang Y, Zhang C, et al. Comparison of efficacy and safety of laparoscopic high ligation of sheathing process and small incision high ligation in the treatment of children with hydrocele and hernia[J]. J Clin Exp Med, 2024, 23(20): 2196-2200.
[3]
赵旌晖, 井颖. 腹腔镜手术与经外环小切口手术治疗小儿精索鞘膜积液的疗效比较[J]. 中国性科学, 2024, 33(10): 31-34.Zhao JH, Jing Y. Comparison of efficacy between laparoscopic surgery and small incision surgery through the external ring for treating pediatric hydrocele of the spermatic cord[J]. Chin J Hum Sex, 2024, 33(10): 31-34.
[4]
Patoulias I, Koutsogiannis E, Panopoulos I, et al. Hydrocele in pediatric population[J]. Acta Medica, 2020, 63(2): 57-62.
[5]
Filmar S, Gross AJ, Hook S, et al. Hydrocele[J]. Urologie, 2024,63(6): 607-617.
[6]
Hoang VT, Van HAT, Hoang TH, et al. A review of classification,diagnosis, and management of hydrocele[J]. J Ultrasound Med, 2024,43(3): 599-607.
[7]
Hall NJ, Ron O, Eaton S, et al. Surgery for hydrocele in children-an avoidable excess?[J]. J Pediatr Surg, 2011, 46(12): 2401-2405.
[8]
中华医学会小儿外科学分会内镜外科学组. 小儿外科日间手术专家共识[J]. 中华小儿外科杂志, 2020, 41(8): 676-682.Expert consensus on pediatric ambulatory surgery[J]. Chin J Pediatr Surg, 2020, 41(8): 676-682.
[9]
Moncel JB, Nardi N, Wodey E, et al. Evaluation of the pediatric post anesthesia discharge scoring system in an ambulatory surgery unit[J].Paediatr Anaesth, 2015, 25(6): 636-641.
[10]
雷东旭, 陈柳妹, 潘永英, 等. 小儿日间手术集中管理模式探讨[J]. 中华小儿外科杂志, 2020, 41(8): 698-703.Lei DX, Chen LM, Pan YY, et al. Perioperative management of pediatric ambulatory surgery[J]. Chin J Pediatr Surg, 2020, 41(8):698-703.
[11]
Fabricant PD, Seeley MA, Rozell JC, et al. Cost savings from utilization of an ambulatory surgery center for orthopaedic day surgery[J]. J Am Acad Orthop Surg, 2016, 24(12): 865-871.
[12]
王志伟, 张黄成昊, 姚桂萍, 等. 小儿腹股沟斜疝及鞘膜积液日间手术疗效与卫生经济学评价[J]. 临床小儿外科杂志, 2024, 23(10):910-917.Wang ZW, Zhang HCH, Yao GP, et al. Efficacy and health economic evaluation of day surgery for pediatric inguinal hernia and hydrocele[J].J Clin Pediatr Surg, 2024, 23(10): 910-917.
[13]
金鑫, 王佚, 刘俊宏, 等. 小儿腹股沟斜疝日间手术与专科住院手术的卫生经济学评价[J]. 中华小儿外科杂志, 2020, 41(1):69-74.Jin X, Wang Y, Liu JH, et al. Comparison of health economical evaluation between day surgery and inpatient hospitalization surgery mode for inguinal hernia[J]. Chin J Pediatr Surg, 2020, 41(1):69-74.
[14]
刘志新, 赵夭望, 陈小林, 等. 株洲市城区3~7岁男童外生殖器发育与相关疾病调查[J]. 中国民康医学, 2017, 29(03): 60-62.Liu ZX, Zhao YW, Chen XL, et al. A survey on external genital development and related diseases in boys aged 3-7 years old in urban Zhuzhou City[J]. Med J Chinese People's Health, 2017, 29(03): 60-62.
[15]
张润, 刘俊宏, 王语, 等. ERAS在儿童鞘膜积液日间手术中的应用价值研究[J]. 重庆医学, 2021, 50(21): 3664-3668.Zhang R, Liu JH, Wang Y, et al. Study on the value of ERAS in day surgery for syringomyelia in children[J]. Chongqing Medicine, 2021,50(21): 3664-3668.
[16]
Esposito C, Escolino M, Turrà F, et al. Current concepts in the management of inguinal hernia and hydrocele in pediatric patients in laparoscopic era[J]. Semin Pediatr Surg, 2016, 25(4): 232-240.
[17]
康延杰, 刘海潮, 刘少朋, 等. 气腹针在单孔腹腔镜鞘状突高位结扎术中的应用[J]. 中国微创外科杂志, 2024, 24(2):150-153.Kang YJ, Liu HC, Liu SP, et al. Application of veress needle in single-port laparoscopic high ligation of Processus vaginalis[J]. Chin J Minim Invasive Surg, 2024, 24(2):150-153.
[18]
Cimador M, Castagnetti M, De Grazia E. Management of hydrocele in adolescent patients[J]. Nat Rev Urol, 2010, 7(7): 379-385.
[19]
张玲玲, 刘华建, 桂萌, 等. 腹腔镜囊肿开窗联合鞘状突结扎治疗儿童腹阴囊鞘膜积液的疗效分析[J]. 腹腔镜外科杂志, 2024,29(3): 222-225,230..Zhang LL, Liu HJ, Gui M, et al. Efficacy analysis of laparoscopic cyst fenestration and Processus vaginalis high ligation in the treatment of abdominoscrotal hydrocele in children[J]. J Laparosc Surg, 2024, 29(3): 222-225,230..
[20]
邱颖, 白东升, 叶辉, 等. 小儿睾丸鞘膜积液鞘膜腔压力对睾丸体积的影响[J]. 中国微创外科杂志, 2019, 19(5): 403-406.Qiu Y, Bai DS, Ye H, et al. Effects of hydrostatic pressure of vaginal cavity on testicular volume in children with hydrocele[J]. Chin J Minim Invasive Surg, 2019, 19(5): 403-406.
[21]
陈进, 段光琦, 刘洁, 等. 单孔腔镜手术与传统腹股沟切口手术治疗儿童鞘膜积液的临床疗效比较[J]. 赣南医学院学报, 2021,41(11): 1114-1118.Chen J, Duan GQ, Liu J, et al. Comparison of clinical efficacy between single port endoscopic surgery and traditional inguinal incision surgery in the treatment of hydrocele in children[J]. J Gannan Med Univ, 2021, 41(11): 1114-1118.
[22]
李智雄, 王星, 刘登瑞, 等. 不同年龄段单侧腹股沟疝及单侧鞘膜积液患儿对侧隐匿性鞘状突未闭的对比研究[J]. 兰州大学学报(医学版), 2020, 46(4): 68-72.Li ZX, Wang X, Liu DR, et al. Prevalence of contralateral patent processus vaginalis in pediatric unilateral indirect inguinal hernia and unilateral hydrocele of different age groups: a comparative study[J]. J Lanzhou Univ Med Sci, 2020, 46(4): 68-72.
[23]
胡伟来, 杨阳. 单侧腹股沟斜疝及单侧鞘膜积液患儿对侧隐匿性鞘状突未闭患病情况分析[J]. 广东医科大学学报, 2018, 36(2):173-176.Hu WL, Yang Y. Analysis on the occult patent processus vaginalis in the children with unilateral oblique inguinal hernia and unilateral hydrocele[J]. J Guangdong Med Univ, 2018, 36(2): 173-176.
[24]
Zakaria OM. Patent contralateral processus vaginalis in infants and children: is herniotomy justified?[J]. Oman Med J, 2018, 33(6): 481-485.
[25]
鲍益耀, 胡书奇, 黄寿奖, 等. 中国小儿日间手术发展的基本现状调查与思考[J]. 中华小儿外科杂志, 2020, 41(8): 692-697.Bao YY, Hu SQ, Huang SJ, et al. Current status and development of pediatric ambulatory surgery in China[J]. Chin J Pediatr Surg, 2020,41(8): 692-697.
[1] 汪鑫, 向涵, 张伟. T型线联合超微创钳辅助经脐单孔腹腔镜胆囊切除术[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(02): 133-133.
[2] 燕速, 霍博文. 腹腔镜食管胃结合部腺癌根治性切除术[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 13-13.
[3] 母德安, 李凯, 张志远, 张伟. 超微创器械辅助单孔腹腔镜下脾部分切除术[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 14-14.
[4] 李国新, 陈新华. 全腹腔镜下全胃切除术食管空肠吻合的临床研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 1-4.
[5] 李子禹, 卢信星, 李双喜, 陕飞. 食管胃结合部腺癌腹腔镜手术重建方式的选择[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 5-8.
[6] 李乐平, 张荣华, 商亮. 腹腔镜食管胃结合部腺癌根治淋巴结清扫策略[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 9-12.
[7] 陈方鹏, 杨大伟, 金从稳. 腹腔镜近端胃癌切除术联合改良食管胃吻合术重建His角对术后反流性食管炎的效果研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 15-18.
[8] 许杰, 李亚俊, 韩军伟. 两种入路下腹腔镜根治性全胃切除术治疗超重胃癌的效果比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 19-22.
[9] 李刘庆, 陈小翔, 吕成余. 全腹腔镜与腹腔镜辅助远端胃癌根治术治疗进展期胃癌的近中期随访比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 23-26.
[10] 任佳, 马胜辉, 王馨, 石秀霞, 蔡淑云. 腹腔镜全胃切除、间置空肠代胃术的临床观察[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 31-34.
[11] 赵丽霞, 王春霞, 陈一锋, 胡东平, 张维胜, 王涛, 张洪来. 内脏型肥胖对腹腔镜直肠癌根治术后早期并发症的影响[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 35-39.
[12] 李博, 贾蓬勃, 李栋, 李小庆. ERCP与LCBDE治疗胆总管结石继发急性重症胆管炎的效果[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 60-63.
[13] 王庆亮, 党兮, 师凯, 刘波. 腹腔镜联合胆道子镜经胆囊管胆总管探查取石术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 313-313.
[14] 杨建辉, 段文斌, 马忠志, 卿宇豪. 腹腔镜下脾部分切除术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 314-314.
[15] 叶劲松, 刘驳强, 柳胜君, 吴浩然. 腹腔镜肝Ⅶ+Ⅷ段背侧段切除[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 315-315.
阅读次数
全文


摘要