TAPP/TEP术中应用改良透壁缝合法固定直疝“假性疝囊”预防术后血肿的效果  

The Effect of Modified Through Wall Suture in TAPP/TEP to Fix the"False Hernia Sac"of Direct Hernia to Prevent Postoperative Hematoma

作　　者：梁正新 段晖 时佳骏 LIANG Zhengxin;DUAN Hui;SHI Jiajun(Tonggu People's Hospital,Jiangxi Province,Tonggu 336200,China)

机构地区：[1]江西省铜鼓县人民医院,江西铜鼓336200

出　　处：《中国医学创新》2023年第15期120-123,共4页Medical Innovation of China

基　　金：宜春市科技计划项目(2022ZDJH6300)。

摘　　要：目的:观察经腹腔腹膜前修补术(TAPP)/全腹膜外修补术(TEP)术中应用改良透壁缝合法固定直疝“假性疝囊”预防术后血肿的效果。方法:选取铜鼓县人民医院2021年1月-2022年3月行TAPP/TEP手术的80例腹股沟直疝患者,用随机数字表法将其分为对照组与研究组,各40例。对照组术中用钉枪法关闭“假性疝囊”,研究组术中用改良透壁缝合法固定直疝“假性疝囊”。记录两组术后2个月内血肿发生情况、手术相关指标、围手术期相关并发症发生情况及术后6个月内疝复发率。结果:研究组术后2个月内血肿发生率较对照组低,差异有统计学意义(P<0.05)。研究组手术时间较对照组长,术后3 d视觉模拟评分法(VAS)评分、医疗总费用均较对照组低,术后住院时间较对照组短,差异均有统计学意义(P<0.05);两组术中出血量对比,差异无统计学意义(P>0.05)。研究组围手术期相关并发症发生率较对照组低,差异有统计学意义(P<0.05)。术后6个月内,两组疝复发率对比,差异无统计学意义(P>0.05)。结论:改良透壁缝合法固定直疝“假性疝囊”可预防TAPP/TEP术后血肿发生,减轻术后疼痛程度,降低围手术期相关并发症发生率,减少医疗费用,利于患者康复。Objective:To observe the effect of modified through wall suture to fix the"false hernia sac"of direct hernia in the operation of transabdominal preperitoneal approach(TAPP)/totally extraperitoneal approach(TEP)to prevent postoperative hematoma.Method:A total of 80 patients with direct inguinal hernia who underwent TAPP/TEP operation in Tonggu People's Hospital from January 2021 to March 2022 were selected and randomly divided into the control group and the study group with 40 cases in each group.In the control group,the"false hernia sac"was closed with nail gun method,while in the study group,the"false hernia sac"of direct hernia was fixed with modified through wall suture method.The incidence of hematoma within 2 months after operation,operation related indexes,occurrence of perioperative related complications and hernia recurrence rate within 6 months after operation were recorded.Result:The incidence of hematoma in the study group was lower than that in the control group within 2 months after operation,and the difference was statistically significant(P<0.05).The operation time of the study group was longer than that of the control group,the visual analogue scale(VAS)score at 3 days after operation and the total medical cost were lower than those of the control group,and the hospital stay was shorter than that of the control group,with statistical significances(P<0.05).There was no significant difference in intraoperative bleeding between the two groups(P>0.05).The total incidence of perioperative complications in the study group was lower than that in the control group,with statistically significant difference(P<0.05).Within 6 months after operation,there was no significant difference in the recurrence rate of hernia between the two groups(P>0.05).Conclusion:The modified through wall suture method for fixing the"false hernia sac"of direct hernia can prevent the occurrence of hematoma after TAPP/TEP,reduce the degree of postoperative pain,reduce the incidence of perioperative complications,reduce medical costs,

关 键 词：腹股沟直疝 腹腔腹膜前修补术 全腹膜外修补术 改良透壁缝合法 血肿 

分 类 号：R656.2[医药卫生—外科学]