改良腹腔镜全腹膜外疝修补术治疗腹股沟疝的效果观察  

Effects of modified laparoscopic totally extraperitoneal prostheic in the treatment of inguinal hernia

作　　者：薛斌[1] 张广斌[1] 鲍广建[2] 

机构地区：[1]枣庄市薛城区人民医院普外科,山东省枣庄277000 [2]枣庄市立医院普外科,山东省枣庄277102

出　　处：《中国基层医药》2017年第24期3807-3810,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 探讨改良腹腔镜全腹膜外疝修补术在腹股沟疝治疗中的应用效果。方法 选取腹股沟 疝患者１００例为研究对象，采用随机数字表法将其分为观察组５０例和对照组５０例，对照组采用开放全腹膜 外疝修补术治疗，观察组采用改良腹腔镜全腹膜外疝修补术治疗，比较两组手术时间、住院时间、下床活动时 间、视觉模拟疼痛评分（ＶＡＳ评分）、并发症及复发情况。结果 两组手术时间差异无统计学意义（Ｐ＞０．０５）； 观察组下床活动时间、住院时间、术后ＶＡＳ评分分别为（１３．５４±３．８１）ｈ、（５．０４±１．２４）ｄ、（３．４６±０．７５）分，对 照组分别为（２５．７６±４．３５）ｈ、（８．３９±１．６５）ｄ、（７．１９±１．２７）分，两组差异均有统计学意义（ｔ＝１４．９４３、 １１４７７、１７．８８２，均Ｐ＜０．０５）；两组阴囊积液、血肿及伤口感染发生率差异均无统计学意义（均Ｐ＞０．０５）；观 察组慢性疼痛、不良反应总发生率分别为２．００％、１０．００％，均低于对照组的１６．００％、３０．００％，差异均有统计 学意义（χ２＝５．９８３、６．２５０，均Ｐ＜０．０５）；观察组复发２例（４．００％），对照组复发３例（６．００％），两组复发率差 异无统计学意义（χ２＝０．２１１，Ｐ＞０．０５）。结论 改良腹腔镜全腹膜外疝修补术治疗腹股沟疝可明显改善术 后疼痛程度，并发症发生率低，临床效果明显优于开放全腹膜外疝修补术。Objective Toinvestigatetheapplicationeffectsofmodifiedlaparoscopictotallyextraperitoneal prostheicinthetreatmentofinguinalhernia.Methods 100patientswithinguinalherniawereselected,andtheywere dividedintocontrolgroup（50cases）andobservationgroup（50cases）accordingtothedigitaltable.Thecontrol groupwastreatedwithopeningtotallyextraperitoneaprosthetic,theobservationgroupwastreatedwithmodified laparoscopictotallyextraperitonealprostheic.Theoperationtime,hospitalstay,leavingbedtime,visualanaloguescale （VASscore）,adversereactionandrecurrencebetweenthetwogroupswerecompared.Results Theoperationtime betweenthetwogroupshadnosignificantdifference（P〈0.05）.Theleavingbedtime,hospitalstayandVASscoreof theobservationgroupwere（13.54±3.81）h,（5.04±1.24）d,（3.46±0.75）points,repectively,whichofthe controlgroupwere（25.76±4.35）h,（8.39±1.65）d,（7.19±1.27）points,repectively,thedifferenceswere statisticallysignificant（t=14.943,11.477,17.882,allP〈0.05）.Therewasnostatisticallysignificantdifferencein theincidenceofscrotaleffusion,hematomaandwoundinfectionbetweenthetwogroups（allP〉0.05）.Theincidence ratesofchronicpain（2.00% vs.16.00%）andadversereactions（10.00% vs.30.00%）intheobservationgroup werelowerthanthoseinthecontrolgroup,thedifferenceswerestatisticallysignificant（χ2 =5.983,6.250,allP〈 005）.After6months′follow-up,2cases（4.00%）occurredrecurrenceintheobservationgroup,3cases（6.00%） occurredrecurrenceinthecontrolgroup,therecurrenceratebetweenthetwogroupshadnostatisticallysignificant difference（χ2=0.211,P〉0.05）.Conclusion Modifiedlaparoscopictotallyextraperitonealprostheiccaneffectively relievethepostoperativepaindegreeandimprovetheadversereactionrate,andwithfastrecovery.

关 键 词：疝 腹股沟 疝修补术 腹腔镜检查 

分 类 号：R656.21[医药卫生—外科学]