会阴区挤压对经腹腹膜前腹股沟疝修补术后快速康复的影响  

Influence of perineal compression on enhanced recovery after transabdominal preperitoneal hernia repair

作　　者：许伟 孙举来[1] 赵中伟[1] XU Wei;SUN Ju-lai;ZHAO Zhong-wei(Department of General Surgery III,Maanshan Central Hospital,Maanshan 210009,China)

机构地区：[1]马鞍山市中心医院

出　　处：《腹腔镜外科杂志》2019年第6期460-463,共4页Journal of Laparoscopic Surgery

摘　　要：目的:探讨会阴区挤压对经腹腹膜前腹股沟疝修补术后快速康复的应用价值。方法:2017年8月至2018年9月施行61例经腹腹膜前腹股沟疝修补术,按随机数字表法将其分为观察组(n=31,无干预措施)与干预组(n=30,术毕挤压阴囊或大阴唇)。对比两组术后24h、2周恢复情况,包括疼痛、异物感、局部并发症、阴囊或大阴唇肿胀、活动受限情况。结果:术后患者均获随访。两组患者年龄、性别、疝类型、缺损大小、手术时间及术后阴囊、大阴唇肿胀发生率差异无统计学意义(P>0.05)。术后24h,两组疼痛评分、异物感、局部并发症及尿潴留发生率差异无统计学意义,但阴囊或大阴唇肿胀缓解率干预组优于观察组(P=0.037)。术后2周,两组疼痛、异物感、阴囊或大阴唇肿胀发生率及活动受限情况差异无统计学意义(P>0.05)。结论:经腹腹膜前腹股沟疝修补术后会阴区挤压可降低早期阴囊或大阴唇肿胀发生率,加速患者康复。Objective:The purpose of this study is to investigate the influence of perineal compression on enhanced recovery after transabdominal preperitoneal ( TAPP) hernia repair.Methods:Sixty-one TAPP cases from Aug.2017 to Sep.2018 were included in this study,and divided into two groups with the method of random number table.No intervention was performed in the observation group ( n = 31) and the scrotum or labia majora was squeezed in intervention group ( n = 30) after the operation.Postoperative recovery was compared between the two groups after 24 h and 2 weeks,including pain,foreign body sensation,local complications,scrotum or labia majora swelling and limited activity.Results:All patients were followed up.There were no significant differences in age,gender,hernia type,defect size,operation time,postoperative scrotal or labia majora swelling between the two groups ( P>0.05).After 24 hours,there was no significant difference between the two groups in pain,foreign body sensation,local complications or urinary retention ( P>0.05). However,the intervention group had better scrotum or labia majora swelling remission rate ( P= 0.037).After two weeks,there were no significant differences in the pain scores,foreign body sensation,scrotum or labia majora swelling residual rate or limited activity between the two groups ( P>0.05).Conclusions:Perineal compression after TAPP can reduce the incidence of early scrotal or labia majora swelling and accelerate the recovery of patients.

关 键 词：疝 腹股沟 腹腔镜检查 经腹腹膜前疝修补术 加速康复外科 会阴挤压 

分 类 号：R656.21[医药卫生—外科学]