| OBJECTIVE:To retrospectively analyze and summarize the results of chest DR diagnosis and perioperative anesthesia and respiratory complications in children with inguinal hernia during the past two years,and to explore the value of conventional chest DR before day surgery.Methods:Statistical analysis of368 children with inguinal hernia undergoing day surgery for routine chest DR who met the inclusion and exclusion criteria from January 2018 to October2019(study group),322 children in the emergency department without routine chest DR before surgery(control group).A total of 690 children’s clinical data,including:name,hospital number,age,gender,discharge diagnosis,preoperative chest DR diagnosis results,intraoperative breathing Systemic complications,PACU respiratory complications,and postoperative anesthesia follow-up respiratory complications.Results:1.General information of the study group:Of the 368 patients in the study group,302 were male and 66 were female;all children aged 8 months to 14 years,of which 89 were less than 1year old and 197 aged 1-3 years old,57 children aged 3-7 years,and 25children aged 7-14 years;132 cases of left inguinal hernia,194 cases of right inguinal hernia,and 42 cases of bilateral inguinal hernia.2.Preoperative chest DR results in the study group:Of the 368 cases,66 were positive for the chest DR and 302 were negative;56 were positive for males and 246 were negative,10 were positive for women and 56 were negative.There was no significant difference in chest DR results between men and women(P>0.05);There were9 positive cases and 80 negative cases in children younger than 1 year old,48positive cases and 149 negative cases in children aged 1-3 years old,6 positive cases and 51 negative cases in children aged 3-7 years old,3 positive cases and22 negative cases in children aged 7-14 years old.There was a significant difference in the diagnosis of chest DR in children of different ages(P<0.05).The positive rate of chest DR in children aged 1-3 years old was higher than that in children of other ages.3.The occurrence of perioperative anesthesia respiratory complications in the study group:there were 16 perioperative anesthesia respiratory complications in 368 cases in the study group,including1 case of bronchospasm,1 case of laryngospasm and 3 cases of phlegmatic during anesthesia induction anesthesia period before extubation;1 case of laryngospasm and 10 cases of phlegmatic during post extubation recovery period;14 cases of male and 2 cases of female in 16 cases,there was no significant difference between male and female(P>0.05).Among the 16patients with anesthesia respiratory complications,14 were less than 1 year old and 2 were 1-3 years old.The difference of anesthesia respiratory complications in different age groups was statistically significant(P<0.01).The proportion of anesthesia respiratory complications in children under 1 year old group was higher than that in other groups(P<0.05).However,there was no correlation between the results of chest DR and the occurrence of anesthesia respiratory complications in children under 1 year old(coefficient R~2=0.021,F=1.866,P>0.05).The results of chest DR in 16 patients with anesthesia respiratory complications were all negative(100.0%).The statistical results showed that:there was no significant difference in the incidence of anesthesia respiratory complications among children with different chest DR results in the study group(P>0.05);the correlation between chest DR results and anesthesia respiratory complications was very small(correlation coefficient R~2=0.01,F=3.672,P>0.05).4.General data of the control group:322 cases in the control group,including 120 cases of acute suppurative appendicitis,36 cases of intestinal obstruction,27 cases of acute appendicitis perforation,23 cases of intussusception,16 cases of testicular torsion,16 cases of incarcerated inguinal hernia,14 cases of congenital anal malformation,11 cases of neck abscess,9cases of skin and soft tissue infection,4 cases of gastrointestinal perforation,2cases of congenital hypertrophic pyloric stenosis,2 cases of scrotal emergency,42 cases of other diseases.There were 224 male and 98 female children,78 aged 1-3 years old,36 aged 1-3 years old,77 aged 3-7 years old and 131 aged 7-14 years old.5.The complications of perioperative anesthesia and respiratory system in the control group:there were 11 cases of perioperative anesthesia complications in the control group,including anesthesia induction anesthesia period before extubation:1 case of lung aspiration,3 cases of phlegm;2 cases of breath holding and 5 cases of phlegm after extubation recovery stage.There were 4 children under 1 year old,3children between 1-3 years old,2 children between 3-7 years old and 2 children between 7-14 years old.There was no significant difference in different age groups(P>0.05).8 male and 3 female and there was no significant difference between children of different genders(P>0.05).Compared with the study group,there was no significant difference in the incidence of respiratory complications between the control group and the study group(P>0.05),and there was no significant difference in the incidence of respiratory complications between the two groups at different stages of anesthesia(P>0.05).Linear correlation analysis showed that the correlation coefficient between preoperative DR examination and anesthesia respiratory complications was R~2=0.024,and there was no statistical significance(F=0.396,P>0.05).Conclusion:1.For the patients with inguinal hernia who have been carefully inquired about their medical history and excluded from respiratory tract infection,there is still a high proportion of DR positive results before operation(17.9%),among which the children aged 1-3 years old account for the most(24.4%).2.The complications of perioperative anesthesia and respiratory system are easy to occur in children less than 1 year old with inguinal hernia during daytime operation,which has no significant correlation with the diagnosis of chest DR.3.There is no significant value in the application of routine chest DR before operation for the selected day operation children with indirect inguinal hernia. |
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