腹腔镜经腹腹膜前疝修补术和Lichtenstein疝修补术对老年男性腹股沟疝的疗效分析  

Clinical analysis of laparoscopic transabdominal preperitoneal hernia repair and Lichtenstein hernia repair for inguinal hernia in elderly men

作　　者：沈浩伟 吴峰[1] 邢栋[1] 陈剑[1] 夏长军[1] 安秋冬 SHEN Hao-wei;WU Feng;XING Dong;CHEN Jian;XIA Chang-jun;AN Qiu-dong(The First Affiliated Hospital of Henan University of TCM,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第一附属医院,郑州450000

出　　处：《医药论坛杂志》2023年第1期5-7,12,共4页Journal of Medical Forum

摘　　要：目的 研究对于老年男性患者腹腔镜经腹腹膜前疝修补术(TAPP)和Lichtenstein疝修补术的临床疗效。方法 以2017年3月至2020年8月在河南中医药大学第一附属医院住院治疗的80例老年男性患者为研究对象,TAPP组37例,Lichtenstein组43例,比较两组患者手术过程、术后不良反应及术后恢复情况。结果 手术操作时间对比Lichtenstein组(70.51±20.27)min, TAPP组(61.81±23.26)min,差异无统计学意义(P>0.05)。术中出血量Lichtenstein组(6.35±3.34)mL,TAPP组(5.67±3.44)mL,差异无统计学意义(P>0.05)。术后排气时间Lichtenstein组(34.84±4.50)h, TAPP组(26.24±5.59)h,差异有统计学意义(P<0.05)。术后住院天数Lichtenstein组(8.53±3.30)d, TAPP组(6.89±1.82)d,差异有统计学意义(P<0.05)。术后第1天及第3天疼痛评分Lichtenstein组(4.79±1.26)、(1.77±1.06),TAPP组(3.19±1.22)、(0.70±0.85),差异均有统计学意义(P<0.05)。血清肿发病率Lichtenstein组17(39.5%),TAPP组6(16.2%),差异有统计学意义(P<0.05)。结论 对于老年男性患者腹腔镜经腹腹膜前疝修补术(TAPP)较Lichtenstein疝修补术不但可以达到相似的手术治疗效果,而且可能术后排气时间短、疼痛水平低、血清肿发生率低,进而缩短了患者的住院时间。Objective To study the clinical effect of laparoscopic transabdominal preperitoneal hernia repair(TAPP) and Lichtenstein hernia repair in elderly male patients.Methods A total of 80 elderly male patients hospitalized in our hospital from March 2017 to August 2020 were selected as the research subjects, including 37 patients in the TAPP group and 43 patients in the Lichtenstein group. The surgical process, postoperative adverse reactions and postoperative recovery of the two groups were compared.Results The operative time was(70.51±20.27)minutes in the Lichtenstein group and(61.81±23.26)minutes in the TAPP group, and the difference was not statistically significant(P>0.05). The intraoperative blood loss was(6.35±3.34)mL in the Lichtenstein group and(5.67±3.44)mL in the TAPP group, with no statistical significance(P>0.05). The postoperative exhaust time was(34.84±4.50)hours in the Lichtenstein group and(26.24±5.59)hours in the TAPP group, and the difference was statistically significant(P<0.05).The length of postoperative hospitalization was(8.53±3.30)days in the Lichtenstein group and(6.89±1.82)days in the TAPP group, and the difference was statistically significant(P<0.05).The pain scores on the first and third days after surgery were(4.79±1.26)and(1.77±1.06)in the Lichtenstein group and(3.19±1.22)and(0.70±0.85)in the TAPP group, the differences were statistically significant(P<0.05).The incidence of seroma was 17(39.5%) in the Lichtenstein group and 6(16.2%) in the TAPP group, and the difference was statistically significant(P<0.05).Conclusion Compared with Lichtenstein hernia repair, laparoscopic transabdominal preperitoneal hernia repair(TAPP) in elderly male patients not only achieve similar surgical results, but also may shorten the length of hospital stay of patients with shorter postoperative exhaust time, lower level of pain, and lower incidence of seroma.

关 键 词：腹腔镜 疝 腹股沟疝 疝修补术 老年人 临床疗效 

分 类 号：R656.21[医药卫生—外科学]