超声刀在腹腔镜完全腹膜外腹股沟疝修补术中应用的前瞻性随机对照研究  

Prospective randomized controlled trial of ultrasonic scalpel in laparoscopic total extraperitoneal inguinal hernia repair

作　　者：钟锋[1,2] 刘红日[3] 何雪梅[2] 王金重[2] ZHONG Fen LIU Hong-ri HE Xue-mei WANG Jin-zhong(Department of General Surgery,Shenzhen Hospital of Southern Medical University,Guangdong Province,Shenzhen 518100,China Department of General Surgery,People＇s Hospital of.Jiangmen City in Guangdong Province,Jiangmen 529000,China Department of Anesthesiology,People＇s Hospital of Jiangmen City in Guangdong Province,Jiangmen 529000,China)

机构地区：[1]南方医科大学深圳医院普通外科,广东深圳518100 [2]广东省江门市人民医院普通外科,广东江门529000 [3]广东省江门市人民医院麻醉科,广东江门529000

出　　处：《中国当代医药》2017年第22期17-19,共3页China Modern Medicine

基　　金：广东省江门市科技计划项目(江科[2014]72号)

摘　　要：目的探讨超声刀在腹腔镜完全腹膜外腹股沟疝修补术中的应用效果。方法选取江门市人民医院2014年4月~2016年10月收治的86例腹股沟疝患者作为研究对象,按照随机数字表法分为观察组(n=43)和对照组(n=43),两组患者均行腹腔镜完全腹膜外腹股沟疝修补术,其中观察组术中使用超声刀,对照组术中使用电凝钩。分别对两组的手术相关指标、术后并发症发生情况以及随访期间复发率进行比较,同时采用视觉模拟评分法(VAS)对两组患者的术后疼痛情况进行评定。结果两组的手术时间、住院费用比较,差异无统计学意义(P>0.05)。观察组的术中出血量少于对照组,术后VAS评分低于对照组,差异有统计学意义(P<0.05)。观察组术后的并发症发生率显著低于对照组,差异有统计学意义(P<0.05)。两组随访期的复发率比较,差异无统计学意义(P>0.05)。结论超声刀在腹腔镜完全腹膜外腹股沟疝修补术中具有一定优势,不仅可以减少术中出血,且能减少并发症,降低手术风险,值得临床推广应用。Objective To investigate the application effect of ultrasonic scalpel in laparoscopic totally extraperitoneal inguinal hernia repair.Methods 86 patients with inguinal hernia treated in People′ s Hospital of Jiangmen City from April 2014 to October 2016 were selected as the research objects,They were divided into the observation group（n=43）and the control group（n=43） according to the random number table method.Two groups of patients were performed laparoscopic totally extraperitoneal inguinal hernia repair.The patients of the observation group were used ultrasonic scalpel,and the patients of the control group were used electric coagulation hook.The operation related indexes,the postoperative complications and recurrence during the follow-up period were compared in the two groups,At the same time,by using visual analogue scale（VAS）,postoperative pain of the two groups patients were assessed.Results There was no significant difference in the operative time,hospitalization expenses between the two groups（P〉0.05）.The intraoperative blood loss of the observation group was significantly less than that in the control group,the postoperative VAS score of the observation group was lower than that of the control group,with significant difference（P〈0.05）.The incidence rate of postoperative complications in the observation group was significantly lower than that in the control group,with significant difference（P〈0.05）.There was no significant difference in the recurrence rate follow-up period between the two groups（P〉 0.05）.Conclusion The application of ultrasonic scalpel has certain advantages in laparoscopic totally extraperitoneal inguinal hernia repair.It can reduce the intraoperative bleeding,avoid the complications,reduce the operation risk,and it is worthy of clinical promotion and application.

关 键 词：超声刀 腹腔镜完全腹膜外腹股沟疝修补术 电凝钩 并发症 

分 类 号：R656.21[医药卫生—外科学]