不同体质量指数对腹腔镜腹股沟疝修补术疗效及并发症的影响  

Effect of different body mass index on the efficacy and complications of laparoscopic inguinal hernia repair

作　　者：于颖娟[1] 

机构地区：[1]绵阳市中心医院普外科,四川621000

出　　处：《中华疝和腹壁外科杂志（电子版）》2017年第4期283-286,共4页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

摘　　要：目的探讨不同体质量指数对腹腔镜腹股沟疝修补术疗效及并发症的影响。方法选择2013年1月至2016年1月,绵阳市中心医院行腹腔镜下无张力疝修补术治疗的腹股沟疝患者348例。根据患者体质量指数分为超重组(112例)和正常组(236例),其中超重组患者行腹腔镜完全腹膜外疝修补术(TEP)58例,腹腔镜经腹腹膜前疝修补术(TAPP)54例;正常组患者行TEP术113例,TAPP术123例,观察2组患者的手术时间、下床活动时间及住院时间,术后并发症及1年复发率情况。结果超重组患者的手术时间、下床活动时间及住院时间均明显多于对照组(P<0.05),术后出现血清肿发生率为7.14%明显高于对照组的1.27(P<0.05),切口感染、阴囊血肿、慢性疼痛、尿潴留、暂时性神经感觉异常等发生率虽高于对照组,但差异无统计学意义(P>0.05),且超重组出现1例补片感染,而对照组并未发生;随访1年超重组患者复发率1.79%与对照组0.42%比较,差异无统计学意义(P>0.05)。结论体质量超重的腹股沟疝患者行腹腔镜下无张力疝修补术治疗,效果显著,但手术难度增加,术后并发症增多,会影响患者术后恢复,因此对于超重及肥胖患者在手术过程中需更加注重精细操作,减少并发症的出现。Objective To investigate the effect of different body mass index on the efficacy and complications of laparoscopic inguinal hernia repair.Methods 348 cases of inguinal hernia treated by laparoscopic tension-free hernia repair in Mianyang central hospital from January 2013 to January 2016 were selected.According to body mass inde, the patients were divided into overweight group （n=112 cases） and normal group （n=236 cases）, including 58 cases of overweight patients underwent TEP surgery, 54 cases of TAPP surgery;113 patients of normal group underwent TEP surgery, 123 cases of TAPP surgery.The operation time, return to activity time and length of hospital stay, postoperative complications and recurrence rate at 1 years after the operations were observed.Results The overweight patients had significantly longer operative time, return to activity time and hospital stay than the control group （P〈0.05）.Postoperative seroma occurred at a rate of 7.14% in the overweight group was significantly higher than that in the control group 1.27% （P〈0.05）.Compared to the control group, the incidence of incision infection, scrotal hematoma, chronic pain, urinary retention and temporary nerve paresthesia were higher in the overweight group, but these differences did not reach statistical significance （P〉0.05）.1 cases of mesh infection occurred in the overweight group, while none in the control group;During 1 year of follow-up, patients recurrence rate was 1.79% and 0.42% in the overweight and control group, respectively.The difference was not significant （P〉0.05）.Conclusion The effect of laparoscopic tension-free hernia repair for the overweight patients with inguinal hernia was remarkable, while increasing the difficulty of surgery and postoperative complications, and will affect postoperative recovery of patients.Therefore, overweight and obese patients need to be paid more attention to the fine operation, reduce the occurrence of complications.

关 键 词：疝 腹股沟 疝修补术 腹腔镜 人体质量指数 

分 类 号：R656.21[医药卫生—外科学]