腹腔镜腹股沟疝修补术在老年腹股沟疝的应用  

Clinical Effects of Transabdominal Preperitoneal Prosthesis in Elderly Inguinal Hernia Patients

作　　者：荆克杰 赵新亮 甘雪思 阮广源 刘日花 JING Kejie;ZHAO Xinliang;GAN Xuesi;RUAN Guangyuan;LIU Rihua(The First Surgical Department,Leliu Medicine Affiliated to Shunde Hospital Guangzhou University of Traditional Chinese Medicine,Foshan Guangdong 528300,China;Department of General Surgery,521 Hospital of Norinco Group,Xi’an Shaanxi 710065,China)

机构地区：[1]广州中医药大学顺德医院附属勒流医院外一科,广东佛山528300 [2]陕西省西安市雁塔区兵器工业五二一医院普通外科,陕西西安710065

出　　处：《中国卫生标准管理》2021年第18期15-18,共4页China Health Standard Management

摘　　要：目的探讨对腹股沟疝老年患者实施腹腔镜下腹股沟疝修补术的临床效果。方法现对2015年1月—2020年3月临床收治的68例腹股沟疝老年患者展开研究,回顾性分析患者的手术治疗方案,根据手术方式的不同将68例患者分为A组和B组,各34例,其中A组患者采用开放无张力疝修补术;而B组患者则实施腹腔镜腹股沟疝修补术(transabdominal preperitoneal prosthesis,TAPP)。记录患者的手术情况,比较两组的疗效差异。结果B组术中出血量(11.09±2.21)mL少于A组(12.54±2.33)mL,切口长度(1.35±0.36)cm、术后下床时间(4.66±1.28)h和住院时长(6.03±1.45)d短于A组(4.12±0.47)cm、(8.62±2.68)h和(9.69±1.91)d,但B组手术时长却长于A组,组间对比差异具有统计学意义(P<0.05);A组和B组术后24 h的疼痛评分均小于术后12 h疼痛评分,组内对比差异具有统计学意义(P<0.05),但B组术后12 h和24 h的疼痛评分小于A组,组间对比差异具有统计学意义(P<0.05);B组术后并发症发生率5.88%小于A组并发症发生率26.47%,组间对比差异具有统计学意义(P<0.05),但A、B两组术后3个月的复发率2.94%和0%未见区别(P>0.05)。结论采用腹腔镜疝修补术治疗老年腹股沟疝患者可以有效减轻其术后疼痛症状,减少术后并发症,在促进患者术后快速恢复的基础上保障治疗的安全性。Objective To discuss the clinical effects of transabdominal preperitoneal prosthesis(TAPP)in elderly inguinal hernia patients.Methods 68 elderly patients with inguinal hernia treated from January 2015 to March 2020 were studied.The surgical treatment schemes of the patients were retrospectively analyzed.According to different surgical methods,68 patients were divided into group A and group B,with 34 cases in each group,patients in group A were treated with open tension-free hernia repair;Patients in group B underwent laparoscopic inguinal hernia repair(TAPP),the operation conditions of the patients were recorded and the curative effects of the two groups were compared.Results The intraoperative bleeding volume in group B(11.09±2.21)mL was less than that in group A(12.54±2.33)mL,the incision length(1.35±0.36)cm,postoperative out of bed time(4.66±1.28)h and hospitalization time(6.03±1.45)d were shorter than those in group A(4.12±0.47)cm,(8.62±2.68)h and(9.69±1.91)d,however,the operation time in group B was longer than that in group A,and the difference between groups was statistically significant(P<0.05);the pain scores at 24 h after operation in group A and group B were lower than those at 12 h after operation,and the difference was statistically significant(P<0.05),however,the pain scores at 12 and 24 hours after operation in group B were lower than those in group A,and the difference between groups was statistically significant(P<0.05);the incidence of postoperative complications in group B was 5.88%,which was less than 26.47%in group A,the difference between groups was statistically significant(P<0.05),however,there was no difference between group A and group B in the recurrence rate of 2.94%and 0%3 months after operation(P>0.05).Conclusion TAPP has advantages of low pain degree,fast recovery,decreased postoperative complication rate and high surgical safety.

关 键 词：腹股沟疝 老年 开放无张力疝修补术 腹腔镜腹股沟疝修补术 疼痛评分 复发率 

分 类 号：R574[医药卫生—消化系统]