腹腔镜和开放疝修补术后患者的生活质量的随机对照研究  

A controlled randomized trial of quality of life in patients after laparoscopic and open hernia repair

作　　者：朱林峰 肖家全[1] 马芳 汪敏徽[1] 张勇[1] Zhu Linfeng;XIAO Jiaquan;MA Fang;WANG Minhui;ZHANG Yong(Department of Gastrointestinal Surgery,Maanshan People′s Hospital,Maanshan 243000,Anhui,China)

机构地区：[1]马鞍山市人民医院胃肠外科,马鞍山243000

出　　处：《东南国防医药》2023年第3期267-271,共5页Military Medical Journal of Southeast China

摘　　要：目的了解疝修补术后患者健康相关的生活质量。方法选择2019年6月至2022年6月在马鞍山市人民医院进行单侧腹股沟疝修补术的101例患者。通过抽签的方式将患者随机分成2组:48例行腹腔镜经腹腹膜前疝无张力修补术(TAPP)为TAPP组;53例行开放式无张力疝修补术(使用Lichtenstein术或Rutkow术)为OHR组。在术后第1、7天,第1、2、6个月进行门诊随访,随访方式包括门诊、电话。第一次随访采用SF-36量表评估患者的生活质量。观察比较2组患者的住院时间、手术时间、术后并发症、疼痛、复发和生活质量等。结果与OHR组对比,TAPP组患者术后第7天疼痛(P=0.003)、住院时间(P=0.000)、术后并发症(P=0.035)、慢性疼痛(P=0.033)具有优势,差异显著。TAPP组的生活质量在躯体疼痛(P=0.015)、总体健康(P=0.010)、生理功能(P=0.009)、生理职能(P=0.024)方面表现更好,差异有统计学意义。然而,心理健康的四个量表中差异无统计学意义(P>0.05),但TAPP组的结果更好。TAPP组的SF-36总分结果更高,差异具有统计学意义(P=0.000)。结论TAPP治疗腹股沟疝可以明显改善术后早期疼痛、生活质量,降低住院时间和术后并发症。Objective To understand the health-related quality of life of patients after hernia repair.Methods A total of 101 patients who underwent unilateral inguinal hernia repair in Ma′anshan People′s Hospital from June 2019 to June 2022 were selected.The patients were randomly divided into two groups:48 patients underwent laparoscopic transabdominal tension-free preperitoneal hernia repair(TAPP)as the TAPP group,OHR group included 53 patients who underwent open tension-free hernia repair(Lichtenstein or Rutkow operation).Patients were followed up at 1,7 days,1,2 and 6 months after surgery by outpatient examination and telephone interview.The quality of life was assessed using the SF-36 scale at the first follow-up.The length of hospital stay,operation time,postoperative complications,pain,recurrence and quality of life were compared between the two groups.Results Compared with the OHR group,the TAPP group had significant advantages in pain 7 days after operation(P=0.003),length of hospital stay(P=0.000),postoperative complications(P=0.035),and chronic pain(P=0.033).The TAPP group performed better in body pain(P=0.015),general health(P=0.010),physical functioning(P=0.009),and role physical(P=0.024).However,there was no statistical significance in the four scales of mental health.The total score of SF-36 in the TAPP group was better than that in the control group(P=0.000).Conclusion TAPP in the treatment of inguinal hernia can significantly improve early postoperative pain,quality of life,and reduce the length of hospital stay and postoperative complications.

关 键 词：腹腔镜 腹腔镜经腹腹膜前疝无张力修补术 疝 生活质量 

分 类 号：R656.21[医药卫生—外科学]