目的:探析疝针联合单孔腹腔镜经阴囊睾丸固定术(HN-SLATO)治疗中低位隐睾的临床疗效.方法:选择石家庄市妇幼保健院儿外科2023年1月至2024年1月收治的80例中低位先天性隐睾患儿,采用随机数字表法分为观察组、对照组各40例.对照组实施传统腹腔镜睾丸引降固定术(LO),观察组实施HN-SLATO治疗,对比两组术后1个月临床疗效、手术情况、温哥华瘢痕量表(VSS)、儿童术后疼痛量表(FLACC)评分、白细胞介素-6(IL-6)、抑制素B(INH-B)和超敏C反应蛋白(hs-CRP)血清学指标,术后1个月并发症发生率.结果:观察组患儿治疗优良率高于显著对照组(97.5％vs75.0％,P＜0.05).两组手术时间、术后住院时间对比无统计学差异(P＞0.05),而观察组睾丸下降成功率显著高于对照组(100％vs85.0％,P＜0.05),VSS评分显著低于对照组(3.3±0.9 vs 4.3±1.0,P＜0.05).两组 FLACC 评分术后 24 h(3.6±0.2;4.1±0.3)、72 h(3.0±0.3;3.5±0.2)较术后2 h(2.2±0.2;2.3±0.1)均显著升高(P＜0.05),但观察组均更低(P＜0.05).术后两组IL-6、INH-B、hs-CRP均较术前升高,且观察组IL-6、hs-CRP升高幅度显著低于对照组(P＜0.05),而INH-B组间对比无差异(P＞0.05).观察组术后并发症发生率显著低于对照组(2.5％vs 20.0％,P＜0.01).结论:HN-SLATO应用于中低位隐睾中效果显著,可有效提高临床疗效及术中睾丸固定效果,提高美观度,减轻患儿疼痛程度,降低血清炎症指标,减少术后并发症.
Randomized controlled trial on the clinical efficacy of hernia needle combined with single port laparoscopic scrotal approach and testicular arch fixation for the treatment of middle and low cryptorchidism in children
Objective:To explore the clinical effect of hernia needle combined with single-port laparoscopy-assisted transscro-tal orchidopexy(HN-SLATO)in the treatment of mid-low cryptorchidism in children.Methods:We selected 80 children with mid-low congenital cryptorchidism treated from January 2023 to January 2024,and equally randomized them into an observation and a con-trol group to receive HN-SLATO and conventional laparoscopic orchidopexy(LO),respectively.We recorded the surgical parameters,the postoperative scores of the patients'on the Face-Legs-Activity-Crying-Consolability Scale(FLACC)and Vancouver Scar Scale(VSS),the serological indicators of interleukin-6(IL-6),inhibitor B(INH-B)and high-sensitivity C-reactive protein(hsCRP),and the incidence of postoperative complications at 1 month after surgery between two groups,followed by comparison between the two groups.Results:The total effectiveness rate of treatment was significantly higher in the observation than in the control group(97.5％vs 75.0％,P＜0.05),and so was the success rate of testicular descent(100％vs 85.0％,P＜0.05),but there was no significant difference in surgical time and postoperative hospital stay between the two groups(P＞0.05).The VSS score was remark-ably lower in the former than in the latter group(3.3±0.9 vs 4.3±1.0,P＜0.05).The FLACC scores were markedly increased in both the observation and control groups at 24 hours(3.6±0.2 and 4.1±0.3)and 72 hours(3.0±0.3 and 3.5±0.2)com-pared with those at 2 hours after surgery(2.2±0.2 and 2.3±0.1)(P＜0.05),but less increased in the former group than in the latter(P＜0.05).The postoperative levels of IL-6,INH-B,and hsCRP were all significantly elevated compared with the baseline in both groups,but less significantly in IL-6 and hsCRP in the observation than in the control group(P＜0.05).The incidence of postoperative com-plications was dramatically lower in the former group than in the latter(2.5％vs 20.0％,P＜0.01).Conclusion:HN-SLATO has a sig-nificant clinical efficiency and high safety in the treatment of mid-low cryptorchidism in children,which can effectively improve intraop-erative fixation and postoperative aesthetics of the testis,as well as reduce pain,serum inflammatory indicators and postoperative com-plications.
万方数据
维普
