目的：探讨单孔腹腔镜治疗小儿腹股沟嵌顿斜疝的疗效。方法2013年3-9月，单孔腹腔镜治疗小儿腹股沟嵌顿斜疝48例。术前诊断右侧嵌顿疝32例，左侧嵌顿疝16例。经脐切口置入trocar建立气腹，置入Z形腹腔镜，经探查孔置入无损伤钳，探查患侧疝内容物类型、嵌顿程度。腹腔镜下辅以体外手法复位将嵌顿疝复位，观察嵌顿脏器损伤情况。如嵌顿脏器无损伤，行腹腔镜下疝囊高位结扎术。探查对侧如存在隐匿疝则同时处理。结果48例均顺利完成单孔腹腔镜手术。术中探查合并对侧隐匿疝10例。嵌顿疝内容物36例为肠管，8例为卵巢，4例为网膜。手法协助复位均顺利还纳，镜下观察5 min，48例嵌顿脏器均血运良好。单侧疝（38例）手术时间10-18 min，平均15 min；双侧疝（10例）手术时间16-30 min，平均24 min。麻醉清醒后进食，疼痛均能耐受。术后10-15 h（平均12 h）出院。随访3-13个月，无切口感染，无阴囊水肿、血肿等并发症，无复发。结论单孔腹腔镜治疗小儿腹股沟嵌顿斜疝不破坏腹股沟管解剖结构，可高位结扎，直视下探查嵌顿疝内容物损伤情况，探查对侧有无隐匿疝。该技术安全、有效、微创，值得推广。

Objective To explore the value of single-port laparoscopic surgery in the treatment of incarcerated indirect inguinal hernia in children . Methods From March to September 2013, a total of 48 cases of incarcerated indirect inguinal hernia were treated by single-hole laparoscopic surgery .Preoperative diagnosis of hernia was right sided in 32 cases and left sided in 16 cases. Via an umbilical incision , one trocar was inserted to establish the pneumoperitoneum .A Z-shaped laparoscope was introduced from the umbilicus, accompanying with a no-damage clamp to explore the lesion and extend of incarceration .If the incarcerated organs were not necrosed , the high ligation of hernial sac was performed .Intraoperatively , contralateral side was explored for finding concealed hernia . Results The single-hole laparoscopic surgery was successfully completed in all the cases .Intraoperative exploration found 10 cases of concealed contralateral hernia .Incarcerated hernia contents included bowel in

目的分析高龄患者腹股沟嵌顿疝的临床特点。方法回顾性分析2013年1月至2014年1月,青海大学附属医院收治的腹股沟嵌顿疝高龄患者12例,分析12例高龄腹股沟嵌顿疝患者围手术期的诊断、治疗及预后。结果 12例高龄腹股沟嵌顿患者中有5例患者合并有其他隐匿性疾病,其住院时间平均17 d,均经积极手术治疗治愈出院。结论高龄腹股沟嵌顿疝患者,由于生理机能退化、临床表现不典型,往往合并隐匿性疾病,其诊断与治疗有其自身的特点。

Objective To investigate the clinical characteristics of incarcerated inguinal hernia in elderly patients.Methods A total of 1 2 cases of older patients with incarcerated inguinal hernia who were admitted to Qinghai University Affiliated Hospital from January 201 3 to January 201 4,were enrolled in this study.The diagnosis,treatment and prognosis in these patients were analyzed.Results 5 patients had other occult comorbidities,and their mean hospital length of stay was 1 7 days.All of them had a discharge after the operation.Conclusions The diagnosis and treatment of incarcerated inguinal hernia in elderly patients have their own characteristics,because of degenerative physiological function and atypical clinical manifestation.In addition,they were frequently found with other occult comorbiditie.

目的探讨平片置入法无张力修补治疗嵌顿性腹股沟疝的临床效果。方法回顾性分析采用平片置入法无张力疝修补治疗的42例腹股沟嵌顿疝患者的临床资料。结果42例患者全部治愈，无切口感染，术后恢复快，随访6～30个月无复发。结论平片置入法一期无张力疝修补术治疗腹股沟嵌顿疝是安全可行的，并发症少，临床效果满意。

Objective To investigate the value of flat mesh tension free hernia repair in the treatment of incarcerated inguinal hernia.Methods The clinical data of 42 patients with incarcerated inguinal hernia treated by fiat mesh tension-free hernia repair were retrospectively analyzed.Results Forty-two patients had healing by first intention with no incision infection,and they were discharged 6-9 days after operation.All cases were followed up for 6-30 months without recurrence.Conclusions Flat mesh tension-free one stage repair for incarcerated inguinal hernia is feasible,with fewer complications and satisfactory clinical results.

目的：评价小儿腹股沟嵌顿疝腹腔镜手术的临床应用价值。方法：对行微型腹腔镜腹股沟嵌顿疝手术55例患儿（腹腔镜组）及同期行开放手术的腹股沟嵌顿疝46例患儿（对照组）的临床资料进行对比分析，对两组患儿的手术时间、出血量、住院时间及术后并发症等进行统计分析。结果：腹腔镜组平均手术时间、出血量、住院时间及术后并发症等显著少于对照组，两组随访均无复发。结论：腹腔镜手术治疗小儿腹股沟嵌顿疝具有损伤小、并发症少等优点。

objective:to evaluate the young child the clinical value of laparoscopic inguinal incarcerated hernia.Methods:the line of miniature 55 cases of laparoscopic inguinal incarcer-ated hernia surgery group (laparoscopic)line and at the same time open surgery of inguinal incarcerated hernia the clinical data of 46 cases of children (control group)were analyzed,the two groups of children with operation time,blood loss,hospital stay and postoperative complications were analyzed.Results:the laparoscopic group average operation time,blood loss,length of hos-pital stay and postoperative complications such as significantly less than the control group,two groups were no recurrence of fol ow-up.Conclusions:laparoscopic surgery in the treatment of pe-diatric inguinal incarcerated hernia has the advantages of lit le injury,fewer complications.

目的探析腹股沟疝无张力修补术及腹股沟嵌顿疝修补术的临床治疗效果。方法将我院接收的45例腹股沟疝患者作为观察对象，分析总结腹股沟疝无张力修补术及腹股沟嵌顿疝修补术的临床效果。结果本组45例患者，有4例患者为急诊手术行腹股沟嵌顿疝修补术，41例患者行腹股沟疝无张力修补术，手术后有4例患者发生尿潴留，2例患者出现阴囊水肿，3例患者有伤口异物感，2例患者有切口哆开。所有患者均随访2~3个月，未见有复发病例。结论腹股沟疝无张力修补手术简单安全创伤小，手术后恢复快。复发率低，是较为理想的手术方式，值得临床应用和推广，腹股沟嵌顿疝急诊手术宜选用传统疝修补术。

Objective To explore surgical repair of inguinal hernia without tension and inguinal incarcerated hernia repair of clinical therapeutic ef ect. Methods 45 patients with inguinal hernia were to be received in our as research object, analysis summary repair and inguinal incarcerated inguinal hernia without tension hernia repair of clinical ef ect. Results 45 patients, there are four patients for emergency operation line of inguinal incarcerated hernia repair, 41 cases of patients with inguinal hernia repair without tension, occur ed in 4 patients urinary retention after operation, 2 cases of patients with scrotal edema, 3 patients had wound foreign body sensation, 2 patients had cut duo. Al patients were fol owed up for 2~3 months, no recur ence cases. Conclusion The inguinal hernia without tension repair operation simple and safe smal trauma, rapid recovery after surgery. The recur ence rate is low, is the ideal way of surgery, worthy of clinical application and popularization