Abstract：【Objective】 To investigate the clinical effect of laparoscopic high ligation of pediatric hernia and its effect on inflammatory factors and intestinal mucosal barrier function. 【 Methods 】 A total of 140 children with hernia treated in our hospital were randomly divided into control group (traditional surgical treatment) and observation group (laparoscopic high ligation of children's hernia), with 70 cases in each group. The operation time, incision length, intraoperative bleeding, first anal exhaust time and hospital stay were recorded. The pain scores 24 hours before operation and 8 and 24 hours after operation were compared between the two groups. The serum C-reactive protein (CRP), interleukin-10 (IL-10) and interleukin-1 were analyzed 24 hours before operation and 24 hours after operation β(IL-1β) And urinary lactulose/mannitol (L/M) ratio, urinary intestinal fatty acid binding protein (iFABP), and the levels of blood D-lactic acid (D-LA) 24 hours before and 24 hoursafter operation were observed.【Results】 The operation time, incision size, intraoperative bleeding, first anal exhaust time and hospital stay in the observation group were lower than those in the control group (P<0.05). At 8 h and 24 h after operation, the pain scores of the two groups were significantly lower than that of the control group, and the difference was statistically significant (P<0.05). 24 hours after operation, the levels of serum CRP, IL-10 and IL-1β in the two groups in the observation group were lower than those in the control group (P<0.05). At 24 hours after operation, the levels of serum D-LA, urinary L/M and IFABP in the control group were higher than those at 24 hours before operation (P<0.05), there was no significant difference in the observation group (P>0.05), and the levels in the observation group were lower than those in the control group (P<0.05). 【Conclusion】Compared with traditional surgery, laparoscopic high ligation of pediatric hernia has better clinical effect in the treatment of pediatric hernia. It can significantly reduce the amount of intraoperative bleeding, shorten the operation time, anal exhaust time and hospital stay, and has less inflammatory stress response and less impact on the function of intestinal mucosal barrier.
管敏. 腹腔镜下小儿疝高位结扎术治疗小儿疝气的效果及对炎症因子和肠黏膜屏障功能的影响[J]. 医学临床研究, 2021, 38(11): 1700-1703.
GUAN Min. Effect of Laparoscopic High Ligation of Hernia in Children and its Effect on Inflammatory Factors and Intestinal Mucosal Barrier Function. JOURNAL OF CLINICAL RESEARCH, 2021, 38(11): 1700-1703.
[1] YEAP E, PACILLI M, NATARAJA R M. Inguinal hernias in children[J].Aust J Gen Pract,2020, 49(1-2):38-43. [2] 陈双, 周太成. 有关儿童腹股沟疝外科治疗思考[J].中国实用外科杂志, 2019, 39(8):795-797. [3] 杨周健, 刘钧, 向波, 等. 开放手术与腹腔镜下手术治疗新生儿嵌顿性腹股沟斜疝的临床疗效比较[J].中国内镜杂志, 2019, 25(9):70-74. [4] 李正, 王慧兰, 吉士俊. 实用小儿外科学[M]. 北京:人民卫生出版社, 2001: 531-535. [5] 王燕惠, 曾祥鑫, 陈锦荣, 等. 单孔腹腔镜与传统开放手术疝囊高位结扎术治疗小儿腹股沟斜疝的对比分析[J].腹腔镜外科杂志, 2020, 25(7):512-515. [6] FRÝBOVÁB, TRčKA J, DOTLAčIL V, et al. Laparoscopic inguinal hernia repair in children via PIRS (percutaneous internal ring suturing)[J].Rozhl Chir,2020, 99(6):277-281. [7] 黄永刚, 王平. 国际儿科内镜手术学组微创入路手术治疗儿童腹股沟疝循证指南解读[J].中华疝和腹壁外科杂志(电子版), 2018, 12(4):247-248. [8] BALOGH B, HAJNAL D, KOVÁCS T, et al. Outcomes of laparoscopic incarcerated inguinal hernia repair in children[J].J Minim Access Surg,2020, 16(1):1-4. [9] ALLAIRE J M, CROWLEY S M, LAW H T, et al. The intestinal epithelium: central coordinator of mucosal immunity[J].Trends Immunol,2018, 39(9):677-696. [10] XUE M,JI X,LIANG H,et al.The effect of fucoidan on intestinal flora and intestinal barrier function in rats with breast cancer[J].Food Funct,2018, 9(2):1214-1223. [11] Wang L, Cui Y L, Zhang Z, et al. Rhubarb monomers protect intestinal mucosal barrier in sepsis via junction proteins[J].Chin Med J (Engl),2017, 130(10):1218-1225. [12] POPESCU G A, JUNG I, CORDO B A, et al. Intestinal fatty acid-binding protein, as a marker of anastomotic leakage after colonic resection in rats[J].Rom J Morphol Embryol,2018, 59(4):1075-1081.
2021, Vol. 38 
