腹腔镜腹股沟疝修补术与开放疝环充填式无张力修补术的临床效果比较  

Comparison of clinical efficacy between laparoscopic inguinal hernia repair and open filling tension-free repair

作　　者：张日雄[1] 吴祖光[1] 李恩[1] 张灼新[1] 曾海敬[1] 李志旺[1] 吴伟胜 ZHANG Ri-xiong;WU Zu-guang;LIEn;ZHANG Zhuo-xin;ZENG Hai-jing;LI Zhi-wang;WU Wei-sheng(First Department of Gastrointestinal Surgery,Meizhou People＇s Hospital,Guangdong Province,Meizhou 514000,China)

机构地区：[1]广东省梅州市人民医院胃肠外一科,广东梅州514000

出　　处：《中国当代医药》2018年第20期31-33,共3页China Modern Medicine

基　　金：广东省医学科学技术研究基金项目(A2015253)

摘　　要：目的分析比较腹腔镜腹股沟疝修补术与开放疝环充填式无张力修补术的临床效果。方法选取2015年1月~2017年1月我院收治的78例腹股沟疝患者,根据随机数字表法将其分为研究组(n=40)和对照组(n=38),两组分别采取腹腔镜疝修补术(TEP)与开放疝环充填式无张力修补术治疗。分析比较两组的围术期指标,并比较术后并发症以及1年内复发情况。结果研究组的术后下床活动时间、住院时间、术后疼痛持续时间均短于对照组(P<0.05),术中出血量少于对照组,差异有统计学意义(P<0.05),两组手术时间差异无统计学意义(P>0.05),但住院费用高于对照组,差异有统计学意义(P<0.05)。两组的切口感染、尿潴留、阴囊血肿以及神经感觉异常等术后并发症发生率比较,差异无统计学意义(P>0.05),两组的术后复发情况比较,差异无统计学意义(P>0.05)。结论 TEP与开放疝环充填式无张力修补术对于腹股沟疝均是安全有效的治疗方法。TEP相对而言更微创,恢复更快,但在术后并发症方面并没有明显的优势,且治疗费用高,建议根据患者的具体情况选择合适的手术方式。Objective To analyze and compare the clinical effects of laparoscopic inguinal hernia repair and open-filling tension-free herniorrhaphy. Methods From January 2015 to January 2017, 78 patients with inguinal hernia were selected. According to random number table method, they were divided into the study group（n =40） and the control group（n=38）. The two groups were treated by laparoscopic herniorrhaphy（TEP） and open hernia ring filling tensionfree repair respectively. The perioperative indexes, postoperative complications and recurrence in one year were analyzed and compared between the two groups. Results The time of getting out of bed, the time of hospitalization and the duration of postoperative pain in the study group were shorter than those in the control group（P〈0.05）, and the amount of intraoperative bleeding was lesser than that in the control group, the differences were statistically significant（P 0.05）. There was no significant difference in the operation time between the two groups（P〉0.05）, but the cost of hospitalization of the study group were higher than those in the control group, the difference was statistically significant（P〈0.05）. The incidence of postoperative complications such as incision infection, urinary retention, scrotal emphysema,serum swelling and neurosensory abnormality were not significantly different between the two groups（P〉0.05）. There was no significant difference in postoperative recurrence between the two groups（P〉0.05）. Conclusion TEP and open hernia ring filling tension-free repair are safe and effective methods for inguinal hernia. Laparoscopic inguinal hernioplasty is more minimally invasive and faster recovery, but there is no obvious advantage in postoperative complications,and the cost of treatment is high. It is recommended to select the appropriate operation method according to the specific conditions of the patients.

关 键 词：腹股沟疝 腹腔镜疝修补术 无张力修补术 疗效比较 

分 类 号：R656.21[医药卫生—外科学]