TEP、TAPP与开放疝修补术治疗老年腹股沟疝的疗效比较  

Comparison of therapeutic effects of TEP,TAPP and open hernia repair in the treatment of inguinal hernia in elderly patients

作　　者：胡良鹤[1] 王贵和[1] 武其文[2] Hu Lianghe;Wang Guihe;Wu Qiwen(Department of Gastrointestinal Surgery,People's Hospital ofTongling City,Tongling,Anhui,244000,P.R.China;Department of Laboratory Medicine,Yijishan Hospital Affiliated to Wannan Medical College,Wuhu,Anhui f 241000,P.R.China)

机构地区：[1]安徽省铜陵市人民医院胃肠外科,安徽铜陵244000 [2]安徽省芜湖市皖南医学院附属弋矶山医院检验科,安徽芜湖241000

出　　处：《老年医学与保健》2023年第4期802-807,共6页Geriatrics & Health Care

基　　金：安徽省科研编制计划(2022AH051221)。

摘　　要：目的观察并比较完全腹膜外腹腔镜疝修补术(TEP)、腹腔镜经腹腔腹膜前补片植入术(TAPP)和开放疝修补术治疗老年腹股沟疝患者的疗效,为患者治疗该病症提供优选方案。方法回顾性选取2017年1月—2023年1月于安徽省铜陵市人民医院就诊的101例老年腹股沟疝患者的临床资料进行分析,根据不同手术方式将患者分为TEP组(35例)、TAPP组(26例)和开放组(40例)。观察并比较3组的围术期指标及术后康复、并发症发生情况;比较3组术后1个月生活质量评分。结果开放组的手术时间显著短于TEP组、TAPP组(均P<0.05);开放组术中出血量多于TEP组,而少于TAPP组(均P<0.05);TEP组手术时间短于TAPP组,术中出血量低于TAPP组(均P<0.05)。开放组术后肠功能恢复时间显著短于TEP组、TAPP组,但恢复正常活动时间、住院时间显著长于TEP组、TAPP组(均P<0.05);开放组术后疼痛评分显著高于TEP组、TAPP组(P<0.05);TEP组术后肠功能恢复时间短于TAPP组(P<0.05);开放组并发症发生率高于TEP组、TAPP组(均P<0.05),而TEP组并发症发生率略高于TAPP组,但差异无统计学意义(P>0.05);TEP组术后1个月生活质量各项评分均高于TAPP组、开放组(均P<0.05)。结论TEP、TAPP、开放疝修补术均为治疗老年腹股沟疝的安全有效方法,其中TEP术可减少患者手术创伤,促进患者术后肠功能恢复,提高其生活质量,安全性可靠,具有一定的临床应用价值。Objective To observe and compare the effects of totally extraperitoneal prosthesis(TEP),transabdominal preperitoneal patch repair(TAPP)and open hernia repair in the treatment of inguinal hernia in elderly patients,and provide optimal treatment options for the disease.Methods The clinical data of 101 elderly patients with inguinal hernia treated in People's Hospital of Tongling City from January 2017 to January 2023 were retrospectively selected and analyzed.They were divided into TEP group(35 cases),TAPP group(26 cases)and open group(40 cases)according to different surgical methods.Perioperative indicators,postoperative recovery and complications were observed and compared among the three groups.The score of life quality at 1 month after surgery were compared among the three groups.Results The operative time of the open group was significantly shorter than that of the TEP group and TAPP group(all P<0.05).The intraoperative blood loss of the open group was more than that of the TEP group,but less than that of the TAPP group(all P<0.05).The operative time of the TEP group was shorter than that of the TAPP group,and the intraoperative blood loss was less than that of the TAPP group(all P<0.05).The postoperative recovery time of intestinal function of the open group was significantly shorter than that of the TEP group and TAPP group,but the recovery time of normal activity and hospitalization time were significantly longer than those of the TEP group and TAPP group(all P<0.05).The postoperative pain score of the open group was significantly higher than that of the TEP group and TAPP group(P<0.05).The postoperative recovery time of intestinal function of the TEP group was shorter than that of the TAPP group(P<0.05).The incidence of complications in the open group was higher than that in the TEP group and TAPP groups(both P<0.05),while the incidence of complications in the TEP group was slightly higher than that in the TAPP group,but the difference was not statistically significant(P>0.05).One month after operation,the

关 键 词：老年 腹股沟疝 完全腹膜外腹腔镜疝修补术 腹腔镜经腹腔腹膜前补片植入术 开放疝修补术 围术期指标 术后康复 

分 类 号：R656.21[医药卫生—外科学]