摘要
目的分析经脐单一部位三通道腹腔镜手术治疗隐睾的临床有效性与安全性。方法选取2017年1月至2019年3月在本院收治的104例隐睾患儿,依照治疗方案分为观察组和对照组,各52例。对照组行开放手术,观察组行经脐单一部位三通道腹腔镜手术。对比两组手术情况、并发症发生率、手术前后睾丸容积变化、苗勒管抑制物质(MIS)、性激素[睾酮(T)、卵泡生成素(FSH)、双氢睾酮(DHT)]水平、一氧化氮(NO)、丙二醛(MDA)、总抗氧化能力(T-AOC)。结果观察组手术时间、术后首次下床活动时间、切口疼痛时间、住院天数均短于对照组,术中出血量少于对照组(P<0.05);术后3、6个月两组睾丸容积较术前明显增加(P<0.05);观察组术后1、5 d血清NO、MDA水平低于对照组,T-AOC水平高于对照组(P<0.05);观察组术后3、6个月MIS、T、DHT水平高于对照组,FSH低于对照组(P<0.05);观察组并发症发生率(5.77%)低于对照组(21.15%,P<0.05)。结论经脐单一部位三通道腹腔镜手术能有效降低隐睾患儿术中出血量,调节血清NO、MDA、T-AOC、MIS及性激素水平,保护睾丸功能,促进睾丸正常发育,且安全性较高。
Objective To analyze the clinical effectiveness and safety of three-channel laparoscopic single-site umbilical surgery for cryptorchidism.Methods A total of 104 children with cryptorchidism in our hospital from January 2017 to March 2019 were selected and grouped according to the treatment plan,with 52 cases in each group.The control group underwent open surgery,and the observation group underwent three-channel laparoscopic surgery through a single part of the umbilicus.Surgical conditions,incidence of complications,changes in testicular volume before and after surgery,mullerian inhibitory substances(MIS),sex hormones[testosterone(T),follicle stimulating hormone(FSH),dihydrotestosterone(DHT)],nitric oxide(NO),malondialdehyde(MDA),total antioxidant capacity(T-AOC)were compared between the two groups.Results The operation time,the first time to get out of bed,the time of incision pain,and the length of hospital stay in the observation group were shorter than those in the control group,and the intraoperative blood loss was less than that in the control group(P<0.05).The testicular volume of the two groups increased significantly after operation at three and six months(P<0.05).The levels of NO and MDA in the observation group were lower than those in the control group,and the levels of T-AOC were higher than those in the control group on the first and fifth postoperative days(P<0.05).In the observation group,the MIS,T,and DHT levels were higher in the third and sixth months after operation,and the FSH was lower than that in the control group(P<0.05).The incidence of complications in the observation group(5.77%)was lower than that in the control group(21.15%,P<0.05).Conclusions Three-channel laparoscopic surgery through a single part of the umbilicus can effectively reduce the amount of bleeding during cryptorchidism,it can regulate the levels of serum NO,MDA,T-AOC,MIS and sex hormones,protect testicular function,promote normal testicular development,and has higher safety.
作者
姜景凯
朱安之
奚玉廷
Jiang Jingkai;Zhu Anzhi;Xi Yuting(Department of Pediatric Surgery,the Second People's Hospital of Liaocheng City,Liaocheng 252600,China)
出处
《国际泌尿系统杂志》
2020年第4期660-664,共5页
International Journal of Urology and Nephrology
关键词
隐睾
儿童
腹腔镜检查
性腺激素
Cryptorchidism
Child
Laparoscopy
Gonadal Hormones
