完全腹膜外腹腔镜疝修补术与腹腔镜经腹腔腹膜前疝修补术治疗腹股沟疝气的疗效对比  

Comparing the efficacy of totally extraperitoneal prosthesis and transabdominal preperitoneal prosthesis in the treatment of inguinal hernia

作　　者：李涛 廖玉华 阳瑾 宋兵海 黄忠勇 张世龙 LI Tao;LIAO Yuhua;YANG Jin;SONG Binghai;HUANG Zhongyong;ZHANG Shilong(General Surgery Department of Chibi People's Hospital,Xianning 437300,Hubei)

机构地区：[1]赤壁市人民医院普外二科,湖北咸宁437300

出　　处：《临床普外科电子杂志》2021年第4期53-58,共6页Journal of General Surgery for Clinicians(Electronic Version)

摘　　要：目的探讨完全腹膜外腹腔镜疝修补术(totally extraperitoneal prosthesis,TEP)与腹腔镜经腹腔腹膜前疝修补术(transabdominal preperitoneal prosthesis,TAPP)治疗腹股沟疝气疗效。方法选取赤壁市人民医院2017年5月至2020年5月收治的腹股沟疝气患者74例,采用随机数字法将患者分成TEP组及TAPP组,每组37例。TEP组接受TEP治疗,TAPP组接受TAPP治疗。比较两组患者一般指标、视觉模拟评分法(visual analogue scale,VAS)疼痛评分、炎性细胞因子水平、并发症发生情况。结果TEP组患者手术时间短于TAPP组(P<0.05),下床活动时间、住院时间、术中出血量与TAPP组差异无显著性(P>0.05)。术前,两组患者VAS评分差异无显著性(P>0.05);术后,TAPP组术后2h、12h患者VAS评分与TEP组差异无显著性(P>0.05)。术前,两组患者白介素-6、C反应蛋白、白细胞计数比较差异无显著性(P>0.05);术后,TAPP组患者白介素-6、C反应蛋白、白细胞计数与TEP组差异无显著性(P>0.05)。TAPP组并发症发生率低于TEP组(P<0.05)。结论TAPP较TEP手术时间短,术后并发症及炎症反应少,疗效可靠。Objective To analyze the efficacy of totally extraperitoneal prosthesis(TEP)and transabdominal preperitoneal prosthesis(TAPP)in the treatment of inguinal hernia.Methods 74 inguinal hernia patients in Chibi People's Hospital from May 2017 to May 2020 were randomly selected and divided into TEP group and TAPP group by random number method,with 37 patients in each group.TEP group received TEP surgical treatment,and TAPP group received TAPP treatment.General indicators,pain,inflammatory cytokine levels and complications were compared between the two groups.Results The time of operation in TEP group was less than that in TAPP group(P<0.05),the time of bed activity,length of hospital stay and intraoperative blood loss were more than that in TAPP group,and the difference was not statistically significant(P>0.05).There was no significant difference in VAS score between the two groups before treatment(P>0.05).VAS scores of patients in the TAPP group 2h and 12h after surgery were lower than those in the TEP group,but the difference was not statistically significant(P>0.05).There was no significant difference in interleukin-6,C-reactive protein and white blood cell levels between the two groups(P>0.05).The levels of interleukin-6,C-reactive protein and white blood cell in the TAPP group were lower than those in the TEP group,but the difference was not statistically significant(P>0.05).The complication rate of TAPP group was lower than that of TEP group(P<0.05).Conclusion Compared with TEP,TAPP has shorter operation time and less postoperative complications and inflammatory reactions.It is reliable efficacy.

关 键 词：完全腹膜外腹腔镜疝修补术 经腹腔腹膜前腹腔镜疝修补术 腹股沟疝气 疗效 

分 类 号：R65[医药卫生—外科学]