腹腔镜TAPP与开放TIPP修补腹股沟疝后患者疼痛及异物感的比较  

Comparison of postoperative pain and foreign body sensation in patients with inguinal hernia treated by laparoscopic transabdominal preperitoneal and open transinguinal preperitoneal

作　　者：高峰[1] 赵明一[1] 林俊青[1] 陈涛 邵建平[1] 刘春庆[1] Gao Feng;Zhao Mingyi;Lin Junqing;Chen Tao;Shao Jianping;Liu Chunqing(Department of General Surgery, Daxing Hospital, Capital Medical University, Beijing 100260, China)

机构地区：[1]首都医科大学大兴医院普外科,北京100260

出　　处：《国际外科学杂志》2019年第5期311-314,共4页International Journal of Surgery

摘　　要：目的比较腹腔镜经腹腹膜前(TAPP)与开放经腹股沟腹膜前(TIPP)修补腹股沟疝后患者的疼痛及异物感。方法回顾性分析2016年1月—2018年1月首都医科大学大兴医院收治的180 例腹股沟疝患者的临床资料,其中男性158例,女性22例;平均年龄56岁,范围23~80岁。按照治疗方法的不同将患者分为TAPP组(n=110)和TIPP组(n=70),TAPP组患者采用腹腔镜TAPP治疗,TIPP组患者采用开放TIPP治疗。采用疼痛视觉模拟评分(VAS)评估两组患者3周、3个月、6个月时的疼痛程度,并统计两组患者术后3周、3个月、6个月时慢性疼痛发生率,记录3个月时异物感发生率。计量资料以均数±标准差(Mean±SD)表示,组间比较采用t检验;计数资料组间比较采用χ2检验。结果术后3周、3个月、6个月时,TAPP组患者疼痛VAS均值低于TIPP组[(0.07±0.40)分比(0.37±0.94)分,(0.03±0.16)分比(0.24±0.69)分,(0.01±0.10)分比(0.14±0.46)分],差异均具有统计学意义(P=0.004、0.002、0.004)。术后3周、3个月、6个月时, TAPP组患者疼痛发生率分别为3.6%、2.7%、0.9%,同时TIPP组患者疼痛发生率分别为14.3%、11.4%、10.0%,两组相比差异均具有统计学意义(P=0.021、0.040、0.012)。术后3个月时,TAPP组患者异物感有2例(1.8%),TIPP组有12例(17.1%),两组比较差异具有统计学意义(χ2=14.006,P=0.000)。结论与开放TIPP方式相比,采用腹腔镜TAPP方式修补腹股沟疝,患者术后疼痛更轻,慢性疼痛及异物感发生率更低。Objective To compara the postoperative pain and foreign body sensation in patients with inguinal hernia treated by laparoscopic transabdominal preperitoneal (TAPP) and open transinguinal preperitoneal (TIPP). Methods Retrospective analysis of clinical data of 180 patients with inguinal hernia admitted to the Daxing District People′s Hospital of Capital Medical University from January 2016 to January 2018, male 158 cases, female 22 cases, average age 56 years old, age range 2380 years old. Including 110 patients in the TAPP group and 70 patients in the TIPP group, patients in the TAPP group were treated with laparoscopic TAPP, and patients in the TIPP group were treated with open TIPP. Pain degree was assessed with pain visual analogue scale (VAS) postoperatively at 3 weeks, 3 months and 6 months. The incidence of chronic pain was measured at 3 weeks, 3 months, and 6 months after surgery, and the incidence of foreign body sensation at 3 months was recorded. Measurement data were expressed as mean ± standard deviation (Mean±SD), t test was used for comparison between groups;Chisquare test was used for compare the count data between groups. Results At 3 weeks, 3 months, and 6 months after surgery, the mean value of pain VAS in the TAPP group was lowerthan in the TIPP group [(0.07±0.40) scores vs (0.37±0.94) scores,(0.03±0.16) scores vs (0.24±0.69) scores,(0.01±0.10) scores vs (0.14±046) scores], and the difference was statistically significant (P=0.004, 0.002, 0.004). The incidence of pain in the TAPP group was 3.6%, 2.7%, and 0.9% at 3 weeks, 3 months, and 6 months after surgery, respectively. The incidence of pain in the TIPP group was 14.3%, 11.4%, and 10.0%, respectively. The difference was statistically significant (P=0.021, 0.040, 0.012). At 3 months postoperatively, there were 2 cases (1.8%) in the TAPP group and 12 cases (17.1%) in the TIPP group with the foreign body sensation. The difference between the two groups was statistically significant (χ2=14.006, P=0.000). Conclusion Compared with

关 键 词：腹腔镜 疝 腹股沟 疼痛 手术后 手术后并发症 开放手术 

分 类 号：R656.21[医药卫生—外科学]