不同通路的腹腔镜腹股沟斜疝修补术的对比性临床研究  

Clinical efficacy research on different laparoscopic surgery for patients with inguinal indirect hernia

作　　者：严聪[1] 吴雄辉[1] 严冰[2] 陈永强[1] 陈志强[1] 何龙娟[3] YAN Cong WU Xiong-hui YAN Bing CHEN Yong-qiang CHEN Zhi-qiang HE Long-juan(The First Department of General Surgery,Center People＇s Hospital of Zhanjiang, Guangdong Provinee,Zhanjiang 524037,China Department of Anesthesiology,Center People＇s Hospital of Zhanjiang,Guangdong Provinee,Zhanjiang 524037,China Department of Hematopathology,Center People＇s Hospital of Zhanjiang,Guangdong Provinee,Zhanjiang 524037,China)

机构地区：[1]广东省湛江中心人民医院普外一科,广东湛江524037 [2]广东省湛江中心人民医院麻醉科,广东湛江524037 [3]广东省湛江中心人民医院血液内科,广东湛江524037

出　　处：《中国当代医药》2017年第15期19-22,共4页China Modern Medicine

基　　金：广东省湛江市科学技术局项目(2013B01028)

摘　　要：目的比较经下肢皮下通路和经皮全腹膜外通路两种不同途径的腹腔镜下腹股沟斜疝修补术在腹股沟斜疝治疗中的临床效果。方法选择2013年9月~2015年8月因腹股沟斜疝在我院治疗的患者86例,随机分为观察组和对照组,各43例。观察组患者采用下肢皮下通路的腹腔镜下腹股沟斜疝修补术(LHR-L),对照组患者采用经皮全腹膜外通路的腹腔镜下腹股沟斜疝修补术治疗。比较两组的临床效果和并发症发生情况。结果 86例患者均成功完成手术。观察组的手术时间、术中出血量和住院费用均少于对照组,差异均有统计学意义(P<0.05)。术后6、24、48 h,观察组的VAS疼痛评分均低于对照组(P<0.05);观察组的SF-36评分均高于对照组(P<0.05)。观察组近期并发症发生率为4.66%,低于对照组的18.60%(P<0.05)。结论 LHR-L治疗腹股沟斜疝具有操作简便、治疗效果确切、术后并发症少且恢复快的优点,可以在临床进一步推广。Objective To compare the clinical efficacy of laparoscopic hernia repair via the limb subcutaneous approach （LHR-L） and laparoscopie hernia repair via the total extraperitoneal approach （LHR-TEP）.Methods A total of 86 pa- tients with inguinal indirect hernia in our hospital from September 2013 to August 2015 were selected and randomly di- vided into observation group and control group,43 eases in each group.Patients in the observation group were given LHR-L and control group were given LHR-TEP.The clinical efficacy and complications of two group were observed and compared.Results All the 86 eases finished operation successfully.The operation time,blood loss within operation, and hospitalization expenses in observation group were less than those of control group with difference being statistically significant （P〈0.05）.At the time of 6,24,and 48 h after operation,the VAS pain scores of observation group was lower than those o1[ control group （P〈0.05）,and the SF-36 scores of observation group was higher than that of control group （P〈0.05）. The recent complication of observation group （4.66%） was lower than those of control group （18.60%） （P〈0.05）.Conclusion LHR-L has the advantage of simple handling,definite efficacy,less postoperative complications and faster recovery, and can be promoted clinically.

关 键 词：腹股沟斜疝 腹腔镜 经下肢皮下通路 

分 类 号：R656.21[医药卫生—外科学]