腹腔镜微创手术治疗中老年腹股沟嵌顿疝的疗效分析  

Efficacy analysis of laparoscopic minimally invasive surgery for incarcerated inguinal hernia in elderly patients

作　　者：郑辉明[1] 戴育坚[1] 王英俊[1] 颜景佳[2] 叶彤[1] 刘震[1] 

机构地区：[1]福建医科大学附属泉州第一医院疝外科,福建泉州362000 [2]福建医科大学附属泉州第一医院麻醉科,福建泉州362000

出　　处：《中国普通外科杂志》2017年第10期1247-1252,共6页China Journal of General Surgery

基　　金：福建省泉州市科技计划基金资助项目(2016Z028)

摘　　要：目的:探讨腹腔镜微创手术治疗中老年腹股沟嵌顿疝的临床疗效。方法:回顾性分析2014年3月—2016年3月收治的中老年腹股沟嵌顿疝患者132例临床资料,其中66例采用腹腔镜微创手术治疗(腔镜组),另66例采用传统无张力疝修补术治疗(传统组)。比较两组患者的相关临床指标。结果:两组术前一般资料与实验室指标均无统计学差异(均P>0.05)。与传统组比较,腔镜组患者住院费用明显升高(P<0.05),手术时间无统计学差异(P>0.05),术中出血量、出现疼痛人数、下床时间、住院时间方面均有明显优势(均P<0.05);术后24 h两组患者的白细胞与炎症介质水平均明显升高(均P<0.05),但腔镜组升高更明显(补片、网塞等异物有关);腔镜组总并发症总发生率与复发率均明显低于传统组(4.55%vs.15.15%;4.55%vs.18.18%,均P<0.05)。结论:腹腔镜微创手术治疗中老年腹股沟嵌顿疝安全有效,具有微创、并发症少、术后恢复快等优点。Objective： To investigate the clinical effect inguinal hernia in elderly patients. Methods： The clinical data of 132 elderly oflaparoscopic minimally invasive surgery in treatment of incarcerated patients with incarcerated inguinal hernia treated in March 2014 to March 2016 were retrospectively analyzed. Of the patients, 66 cases underwent laparoscopic minimally invasive surgery （laparoscopic group）, and the other 66 cases underwent traditional open tension-free hernia repair （traditional group）. The main clinical variables between the two groups of patients were compared. Results： The preoperative general data and laboratory parameters showed no significant difference between the two groups （all P〉0.05）. In laparoscopic group compared with traditional group, the hospitalization cost was significantly increased （P〈0.05） and the operative time showed no significant difference （P〉0.05）, but the variables that included intraoperative blood loss, number of pain sufferers, time to ambulation and length of hospital stay were all significantly superior （all P〈0.05）. The white blood cell count and levels of inflammatory mediators in both groups of patients were significantly increased at 24-h after operation compared with their preoperative values （all P〈0.05）, but the increasing amplitudes were significantly evident in laparoscopic group （caused by foreign objects such as patch and mesh-plug）. The overall incidence of complications and recurrence rate in laparoscopic group were significantly lower than those in traditional group （4.55% vs. 15.15%; 4.55% vs. 18.18%, both P〈0.05）. Conclusion： Laparoscopic minimally invasive surgery is safe and effective in treatment of incarcerated inguinal hernia in elderly patients, with the advantages of minimally invasive, reduced complications and fast postoperative recovery.

关 键 词：疝 腹股沟 腹腔镜 最小侵入性外科手术 老年人 

分 类 号：R656.2[医药卫生—外科学]