| Objective:This article is to summarize and analyze the treatment experience and the clinical features of little infants(≦3moths) inguinal hernia in both elective surgery group and emergency surgery group and to find out the risk factors of emergency group.Compare the treatment effects of the two groups, and discuss the choice of treatment beginning.Materials and Methods:Collect the clinical data of Inguinal hernia infants(0-3months) receiving surgical treatment in Children’s Hospital of Soochow University during September 2012 to September 2015.Inguinal hernia infants was divided into elective surgery group and emergency surgery group,arrange all infants’ months of pathogenesis,time of pathogenesis,birth weight, gestational age, the number of incarcerated,he number of treatment,emergency surgery or not,the approach of surgery,Intraoperative conditions(combined tissue necrosis, further diagnosis),postoperative recovery time,the cost of treatment, complications,follow-up and relapse happening,children’s raising up situation,parents education level and other indicators,analyzing data with SPSS 17.0.Comparing and analyzing the treatment effect between the two groups and risk factors for an emergency surgery. Comparing two groups of data, measurement data meeting the normally distributed was analysed with the t test; on the contrary,the date was analysed with rank sum test.P< 0.05,the statistics difference exists,P < 0.01,the difference was significant; COX proportional hazards model was established,analyzed the stronger risk factors of incarcerated inguinal hernia in infants with inguinal hernia.Results: From September 2012 to September 2015,there were 169 cases of infants with inguinal hernia treated by surgery,10 cases refused surgery,8 cases of them received surgery after 4-18 months’ following up,2 cases with low birth weight didn’trelapse,and are following up now.The remaining 159 cases receive surgery,M: F = 1.4:1.There were 54 cases in emergency surgery group,M: F = 1: 1.8. There were 105 cases in elective surgery group,M: F = 2.5: 1.The risk of surgery because of incarceration of low birth weight infants was higher than normal birth weight infants.COX proportional hazard analysis showed HR = 3.06; 95% CI, 2.76 ~ 3.56; P = 0.031.And in the emergency surgery group,94%(51/54) of incarceration infants was the first time, and incarceration time was unknown,COX proportional hazard analysis shows the time of incarcerated was 1, the course of time(days), the statistics difference exists(P<0.05).The misdiagnosis rate of incarcerated inguinal hernia was 20%.The age of diagnosis in emergency surgery group was older than elective surgery group,the elective group was40.01±2.19 d, emergency group was 53.35±3.55 dthe difference was significant(P<0.01);In tissue injury resection,narcotic risk, operation time, minimally invasive recurrence,supplementary diagnosis,the statistics difference are exists(P<0.05).Intraoperative supplementary diagnostic all found in the laparoscopic approach. Because preoperative diagnosis of unilateral lesions or implemented emergency surgery in children with traditional surgery, follow-up found that about 6.2%(5/80) when different hernia. Or whether emergency elective surgery group, the recurrence rate of LP group lower than OP group,there was statistical difference, LP group patients were followed up almost no surgical incision.Conclusion:1.Low birth weight male infants incarcerated hernia easily combined with septic shock, tissue necrosis, after birth should be missionary, so early detection, early intervention.2.Improve pediatricians awareness of the incarcerated hernia in the little infants,early assessment by a specialist for the best timing of surgery to prevent ischemic necrosis of tissues and organs incarcerated.3.Laparoscopic approach forinfants hernia repair is safe and effective, no scars,fewer complications, and can be found contralateral inguinal hernia, avoid the secondsurgery in children, should be the preferred surgical approach in the patients who were younger than 3 moths of age.4.The incarcerated hernia infants can be applied Laparoscopicapproach forinfants hernia repair. |
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