肌耻骨孔的空间分离解剖在腹腔镜全腹膜外疝修补术中的应用及意义  

Space separation of myopectineal orifice in laparoscopic total extraperitoneal hernia repair

作　　者：雷云鹏[1] 何立锐[1] 吕国庆[1] 李冠[1] 邓兴明[1] 

机构地区：[1]北京大学深圳医院胃肠外科,广东深圳518036

出　　处：《中华疝和腹壁外科杂志（电子版）》2015年第6期19-21,共3页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

摘　　要：目的研究肌耻骨孔的空间分离解剖在完全腹膜外疝修补术(TEP)中的应用效果及意义。方法从2013年10月至2015年4月于北京大学深圳医院实施腹腔镜TEP的患者中随机选取112例。根据数字法随机分为观察组56例,对照组56例,对照组实施单纯腹腔镜TEP,观察组在腹腔镜TEP下结合肌耻骨孔的空间分离解剖,观察并对比二组临床效果。结果观察组进食时间(6.5±1.2)min、手术时间(48.6±3.3)min、术后住院时间(5.4±1.2)d、术后下床时间(1.0±0.1)d,均低于对照组的(9.6±2.2)min、(65.5±2.8)min、(7.5±2.1)d、(1.9±0.3)d,差异均有统计学意义(P均<0.05)。观察组术后并发症发生率慢性疼痛8.93%、感觉神经异常3.57%、阴囊血肿1.79%,均低于对照组的23.21%、16.07%、12.50%,差异均有统计学意义(P均<0.05)。观察组治疗疗效为优所占比例67.86%、优良率89.29%,均高于对照组48.21%、73.21%,差异均有统计学意义(P均<0.05)。结论腹腔镜TEP中运用肌耻骨孔的空间分离解剖,便于理解与掌握,能显著减少患者并发症发生率,提高手术效率与质量,安全性高,值得推荐。Objective To explore the application effect and significance of the space separation of myopectineal orifice in laparoscopic total extraperitoneal hernia repair（ TEP）. Methods From October2013 to April 2015,a total of 112 cases who underwent laparoscopic TEP in Shenzhen Hospital were randomly selected into this study. According to the random number,the patients were performed with simple TEP（ control group, n = 56） or with combined TEP and space separation of myopectineal orifice（ observation group,n = = 56）. The clinical effects were observed and compared in the two groups. Results The time to oral intake in observation group was（ 6. 5 ± 1. 2） minutes,operation time was（ 48. 6 ±3. 3） minutes,postoperative hospitalization time was（ 5. 4 ± 1. 2） days,and time to ambulate was（ 1. 0 ±0. 1） days,were significantly lower than those in the control group [（ 9. 6 ± 2. 2） minutes,（ 65. 5 ±2. 8） minutes,（ 7. 5 ± 2. 1） days and（ 1. 9 ± 0. 3） days,respectively; P 0. 05]. The patients in observation group had chronic pain rate at 8. 93%,abnormal sensation rate at 3. 57%,and scrotal hematoma rate at 1. 79%; those were significantly lower than patients in control group（ 23. 21%,16. 07% and12. 50%,respectively; P 0. 05）. The clinical outcome in observation group was＂excellent＂in 67. 86%,and＂excellent or good＂in 89. 29%,which were significantly higher than those in control group（ 48. 21%and 73. 21%, respectively; P 0. 05）. Conclusion Space separation of myopectineal orifice in laparoscopic TEP shows to be easy to understand and handle,can significantly reduce the incidence of complications and improve the efficiency and quality of operation with high security, is worthy of recommendation.

关 键 词：疝 腹股沟 疝修补术 肌耻骨孔 空间分离解剖 腹腔镜检查 

分 类 号：R656.2[医药卫生—外科学]