非吸收高分子结扎夹在腹腔镜全腹膜外腹股沟疝修补术中的临床应用  

Clinical application of nonabsorbable polymer ligation clip in totally extraperitoneal laparoscopic techniques for inguinal hernia repair

作　　者：杨振熙[1] 邱晓峰[1] YANG Zhen-xi;QIU Xiao-feng(Department of General Surgery,the Seventh People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200137,CHINA)

机构地区：[1]上海中医药大学附属第七人民医院普外科,上海200137

出　　处：《海南医学》2018年第24期3449-3451,共3页Hainan Medical Journal

基　　金：上海市浦东新区卫计委学科建设计划项目(编号:PWZ262017-13)

摘　　要：目的探讨非吸收高分子结扎夹在腹腔镜全腹膜外腹股沟疝修补术(TEP)中的临床应用效果。方法回顾性选取上海中医药大学附属第七人民医院普外科2012年1月至2017年12月收治的96例腹股沟疝行TEP手术且术中发生腹膜破口的患者为研究对象,根据处理方案将患者分为观察组和对照组,每组48例。观察组在术中应用非吸收高分子结扎夹,对照组腹股沟疝行经腹腔途径腹膜前补片置入术(TAPP)手术(TEP手术中转)且应用常规可吸收缝线。比较两组患者的手术时间、住院时间、并发症发生率以及患者术后满意度。结果观察组患者的手术时间、术中出血量和住院时间分别为(58.7±4.8) min、(23.4±12.1) mL和(3.2±0.2) d,明显低于对照组的(77.4±5.7) min、(35.6±11.4) m L和(4.4±0.5) d,组间比较差异均具有统计学意义(P<0.05);观察组患者术后发生并发症3例(6.25%),明显低于对照组的10例(20.83%),患者对手术效果的满意度(46/48,95.83%)明显高于对照组的(36/48,75.00%),组间比较差异均具有统计学意义(P<0.05)。结论 TEP手术中在发生腹膜破口漏气情况下使用非吸收高分子结扎夹闭合腹膜的临床应用效果良好,缩短了手术时间和住院时间、减少了并发症的发生率,也提升了患者满意度,值得临床推广。Objective To investigate the clinical application of nonabsorbable polymer ligation clip in total extraperitoneal (TEP)laparoscopic techniques for inguinal hernia repair.Methods From January 2012 to December 2017,96 patients with inguinal hernia,who underwent TEP and had intraperitoneal rupture during the operation in Department of General Surgery of the Seventh People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,were divided into the observation group and the control group according to surgery program,with 48 cases in each group.The observation group used nonabsorbent polymer ligation clip during operation,and the control group underwent transabdominal preperitoneal prosthetic (TAPP)and used conventional absorbable sutures.The operation time,hospitalization time,complication rate,and satisfaction of the two groups after surgery were compared.Results After treatment,the operation time,intraoperative blood loss and hospitalization time of the observation group were (58.7±4.8)min, (23.4±12.1)mL and (3.2±0.2)d,respectively,which were significantly lower than corresponding (77.4±5.7)min, (35.6±11.4)mL and (4.4±0.5)d of the control group (all,P<0.05).The postoperative complications in the observation group were 3 cases (6.25%),which was significantly lower than 10 cases (20.83%)of the control group (P<0.05);the satisfaction rate in the observation group was 46 cases (95.83%)versus 36 cases (75.00%)in the control group (P<0.05). Conclusion Nonabsorbent polymer ligature clip can be used in the TEP laparoscopic techniques for inguinal hernia repair.The clinical application of closed peritoneum is good by shortening the operation time and hospitalization time,reducing the incidence of complications and improving patient satisfaction,which is worthy of clinical promotion.

关 键 词：高分子结扎夹 腹腔镜 全腹膜外腹股沟疝修补术 经腹腔途径腹膜前补片置入术 腹膜破口 并发症 

分 类 号：R656.21[医药卫生—外科学]