腹腔镜与开放无张力疝修补术治疗成人脐疝临床效果分析  

Clinical effect of laparoscopic and open umbilical hernia repair for adult umbilical hernia

作　　者：赵明一[1] 高峰[1] 陈涛[1] 邵建平[1] 林俊青[1] 刘春庆[1] Zhao Mingyi;Gao Feng;Chen Tao;Shao Jianping;Lin Junqing;Liu Chunqing(Department of General Surgery, People′s Hospital of Beijing Daxing District, Beijing 102600, China)

机构地区：[1]北京市大兴区人民医院普外科,102600

出　　处：《国际外科学杂志》2019年第4期246-250,共5页International Journal of Surgery

摘　　要：目的对比分析腹腔镜手术和开放手术治疗脐疝的临床疗效。方法将2008年2月—2017年1月,北京市大兴区人民医院普外科收治的83例成人脐疝手术患者按随机数字表法分成腹腔镜手术组(n=38)和开放手术组(n=45)。腹腔镜手术组患者腹腔内放置补片,开放手术组患者腹膜前间隙放置补片。采用统计学软件SPSS 22.0统计分析两组患者手术时间、住院时间、术中出血量、伤口感染和积液发病率、不全肠梗阻发病率以及疝复发率。术后2周、第1、3、6个月采用门诊复诊方式,随访内容为伤口情况、疼痛情况及脐部是否有包块再突出。之后每3个月电话随访或门诊复诊,内容脐部是否有包块再突出,平均随访时间为14个月。结果所有手术均顺利完成。腹腔镜手术组手术时间明显短于开放手术组[(31±8) min比(48±10) min, P<0.01],术中出血量腹腔镜手术组患者明显少于开放手术组[(40±18) ml比(62±25) ml, P<0.01],术后早期疼痛(术后第3、7、14天)腹腔镜手术组患者明显轻于开放手术组(P<0.05)。术后并发症主要为血清肿和伤口感染、不全肠梗阻。其中两组患者血清肿、切口感染及复发率差异无统计学意义(P>0.05)。不全肠梗阻腹腔镜手术组有0例,开放手术组6例,差异有统计学意义(P=0.019)。术后总的并发症发生率腹腔镜手术组低于开放手术组差异有统计学意义(χ^2=5.328,P=0.021)。结论腹腔镜手术手术时间短、出血量少,术后疼痛轻,患者满意度好,对于可耐受全身麻醉的脐疝患者值得提倡。Objective To compare the clinical effect of laparoscopic and open umbilical hernia repair for adult umbilicalhernia. Methods Eighty-threepatients with adult umbilical hernia admitted to People′s Hospital of Beijing Daxing District from Feb. 2008 to Jan. 2017 were randomly divided into laparoscopic umbilical hernia repair group (n=38) and open umbilical hernia repair group (n=45). Patients in laparoscopic umbilical hernia repair group accepted laparoscopic umbilical hernia repair with intraperitoneal onlay mesh (n=38), while patients in open umbilical hernia repair group accepted traditional umbilical hernia repairtreatment.Operation time, hospital stay, blood loss, seroma/hematoma formation, wound infection, incomplete bowel obstruction and recurrence were compared between the two groups with the software of SPSS 22.0. The outpatient consultation was performed at 2 weeks, 1 month, 3 months, and 6 months after operation. The follow-up contents were wound condition, pain, and whether there were any masses in the umbilicus. After every 3 months of telephone follow-up or outpatient review, whether there were any masses in the umbilicus, the average follow-up time was 14 months. Results All operations were successfully completed. The operation time of laparoscopic umbilical hernia repair group was shorter than open umbilical hernia repair group [(31±8) min vs (48±10) min, P<0.01], and hospital stay were significantly shortened in laparoscopic umbilical hernia repair group (P<0.05). The amount of bleeding of the laparoscopic umbilical hernia repair group decreased significantly than open umbilical hernia repair group [(40±18) ml vs (62±25) ml, P<0.01]. The postoperative painof the laparoscopic umbilical hernia repair group was mild than open umbilical hernia repair group (P<0.05). The postoperative complications include seroma, wound infection and incomplete bowel obstruction. There were no significant differences between the two groups of seroma, incision infection and recurrence(P>0.05). The difference of the i

关 键 词：疝 脐 腹腔镜 外科手术 治疗结果 

分 类 号：R656.2[医药卫生—外科学]