腹腔镜疝修补术对患者术后生活质量的影响的前瞻性随机对照研究  

Effect of laparoscopic hernia repair on postoperative quality of life:A prospective randomized controlled study

作　　者：刘伟[1] 王富芳 Liu Wei;Wang Fufang(Department of General Surgery,Taishan People's Hospital,Tai'an City 271000,China)

机构地区：[1]山东省泰安市泰山区人民医院普外科,271000

出　　处：《中华疝和腹壁外科杂志（电子版）》2020年第4期416-419,共4页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

摘　　要：目的探讨腹腔镜全腹膜外疝修补(TEP)术与腹腔镜经腹腹膜前疝修补(TAPP)术治疗成人腹股沟疝对术后生活质量的影响。方法选取2017年1月至2018年12月,泰安市泰山区人民医院收治的114例腹股沟疝患者为受试对象,以随机数表法分为观察组与对照组各57例。观察组行TEP术,对照组行TAPP术。分析围手术期基本指标及术后12个月时生活质量[简明健康调查表(SF-36)]、慢性疼痛情况[腹股沟疼痛调查表(IPQ)]、并发症发生情况差异。结果观察组手术时间明显少于对照组(P<0.05),而2组术中出血量、术后下床活动时间、术后肠鸣音时间及住院时间比较均无统计学意义(P>0.05)。术后12个月时,2组SF-36生理机能、生理职能、一般健康状况、精力、社会功能、感情职能、精神健康评分比较,差异均无统计学意义(P>0.05),而观察组SF-36躯体疼痛评分明显高于对照组(P<0.05);观察组IPQ评分明显低于对照组(P<0.05)。术后6个月内,2组血肿、血清肿、复发、感染等并发症差异无统计学意义(P>0.05)。结论腹腔镜疝修补术治疗成人腹股沟疝可取得较为理想的疗效,TEP手术在术后疼痛方面较TAPP手术存在一定优势,有利于患者预后康复。Objective To investigate the effect of laparoscopic total extraperitoneal hernia repair(TEP)and laparoscopic trans-abdominal preperitoneal hernia repair(TAPP)on postoperative quality of life in adults with inguinal hernia.Methods A total of 114 patients from Taishan People's Hospital during January 2017 to December 2018 with inguinal hernia were selected as subjects.They were divided into observation group and control group by random number table method,with 57 cases in each group.Observation group underwent modified TEP and control group underwent TAPP.The perioperative basic indicators and quality of life[Short-form Health Questionnaire(SF-36)],chronic pain[inguinal pain questionnaire(IPQ)]and occurrence of complications at 12 months after operation were analyzed.Results The operative time in observation group was significantly lower than that in control group(P<0.05),and there were no significant differences in the intraoperative blood loss,postoperative ambulation time,postoperative bowel sound duration and hospital stay between the two groups(P>0.05).At 12 months after operation,there were no statistically significant differences in the scores of physical functioning,physical role,general health status,energy,social function,emotional function and mental health of SF-36 scale between the two groups(P>0.05),and the body pain score of SF-36 in observation group was significantly higher than that in control group(P<0.05).The IPQ score in observation group was significantly lower than that in control group(P<0.05).Within 6 months after operation,the incidence rate of seroma in observation group was significantly lower than that in control group(P<0.05),there was no significant difference in hematoma,seroma,recurrence,infection and other complications between two groups(P>0.05).Conclusion Laparoscopic hernia repair in the treatment of adult inguinal hernia can achieve ideal effect.TEP procedure has certain advantages over TAPP procedure in postoperative pain,which is beneficial to the prognosis and rehabilitation

关 键 词：疝 腹股沟 腹腔镜 疝修补术 并发症 生活质量 

分 类 号：R656.21[医药卫生—外科学]