摘要
目的：了解新疆维吾尔族儿童腹股沟疝患病率及手术治疗效果。方法2014年6~8月采用整体抽样法对新疆维吾尔自治区乌鲁木齐市和吐鲁番地区的幼儿园、小学及初中儿童进行体格检查,对患腹股沟疝和曾行腹股沟疝手术的儿童进行问卷调查,分析发病高危因素,并对患腹股沟疝的贫困家庭儿童免费进行腹腔镜下腹股沟疝内环口关闭术。结果本次共查体6464例儿童,年龄4~14岁,其中男3288例,女3176例,总计患儿245例,其中男216例,女29例,男患病率6.57%,女患病率0.91%,平均患病率为3.79%,乌鲁木齐市患病率达2.29%,吐鲁番地区患病率达4.25%,吐鲁番地区高于乌鲁木齐市,差异有统计学意义(χ2=75.347,P<0.001)。在245例腹股沟疝患儿中,其中109例为贫困家庭儿童,进行腹腔镜下腹股沟疝内环口关闭术,其中4例患儿中转开腹行腹股沟疝疝囊高位结扎术,未见明显近期并发症及复发病例。结论两个地区之间因地理环境的不同,患病率也有差异,吐鲁番地区明显高于乌鲁木齐市,吐鲁番地区成为儿童腹股沟疝高发的主要原因有高温引起的先天性发育不足、具有家族遗传史和被动吸烟率高。其次,通过此次流行病学调查总结,就小儿腹股沟疝的治疗、一级预防及制定的相关措施向政府及相关机构提供了可靠依据,并为贫困家庭腹股沟疝儿童提供免费医疗条件,通过早期干预,对患儿进行早期指导治疗,从而减少医疗费用和不良并发症。
Abstract
Objective To investigate the prevalence rate and the effect of surgical treatment of inguinal hernia in Uyghur children. Methods The clustering sampling method was performed to the children in the kindergartens, primary and junior middle schools from Urumqi and Turpan regions, from June to August in 2014. After medical examination, the children with inguinal hernia or those who had undergone hernia repair were enrolled in a questionnaire investigation to analyze the risk factors. And the free laparoscopic inguinal hernia repair was performed for the children with inguinal hernia from poor families. Results The total of 6 464 children, including 3 288 males and 3 176 females from 4 to 14 years old, were examined. A total of 245 cases of inguinal hernia were detected, including 216 males ( prevalence rate of 6.57%) and 29 females (prevalence rate of 0. 91%), with the mean prevalence rate of 3. 79%. The prevalence rate in Turpan (4. 25%) was significantly higher than that in Urumqi (2. 29%) (χ2=75. 347, P<0. 001). Among those 245 children with inguinal hernia, 109 of them were from poor families and they were performed with free laparoscopic inguinal hernia repair, with 4 cases of conversion to laparotomy. No significant complications and recurrence were occurred. Conclusion The prevalence rate was varying between the regions due to different geographical environment. Geographical altitude of Turpan is higher than Urumqi. The main risk factors for higher prevalence rate of pediatric inguinal hernia in Turpan may include the congenital dysplasia caused by high temperature, family history of inguinal hernia and high passive smoking rate. Moreover, the treatment for pediatric inguinal hernia, primary prevention and established measures have been provided a reliable basis to the government or relevant departments by the summary from epidemiological investigation, and it also offers free medical care to poor families. With the intervention and guiding treatment at earlier period, it could reduce the medical costs and postoperative adverse complications.
基金项目
新疆维吾尔自治区人民医院院内课题(20130214)
NETL
NSTL
维普
万方数据