腹腔镜下经腹腔腹膜前疝修补术治疗嵌顿性股疝的临床效果研究  

Clinical analysis of laparoscopic transabdominal preperitoneal herniorrhaphy in incarcerated femoral hernia

作　　者：杜海伟 宋晓冬 路军华[1] 陈清海[1] DU Hai-wei;SONG Xiao-dong;LU Jun-hua(General Surgery Department of the First Teaching Hospital of Tianjin University of Chinese Traditional Medicine/National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,Tianjin(300380),China)

机构地区：[1]天津中医药大学第一附属医院·国家中医针灸临床医学研究中心,天津300380

出　　处：《中国中西医结合外科杂志》2024年第2期233-237,共5页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:探讨腹腔镜下经腹腔腹膜前疝修补术(TAPP)在治疗嵌顿性股疝方面的安全性及有效性。方法:回顾分析2017年4月—2021年12月天津中医药大学第一附属医院收治的30例嵌顿性股疝患者的临床资料,根据手术方式分为腹腔镜组17例,开放组13例,比较两组患者的手术情况、住院时间、并发症及随访结果等。结果:腹腔镜组手术时间[(71.35±10.48)min vs(86.90±12.54)min,P=0.010]、术中出血量[(17.06±3.40)m L vs(33.69±6.55)m L,P<0.001]、住院天数少于开放组[(5.90±1.30)d vs(8.23±9.93)d,P<0.001],术后疼痛评分低于开放组[(1.12±0.33)vs(2.09±0.70),P<0.001],术后排气时间短于开放组[(14.82±4.20)h vs(21.64±3.17)h,P<0.001],差异均有统计学意义;两组术后并发症无统计差异,术后随访1年,两组患者均未见复发。结论:TAPP手术治疗嵌顿性股疝是安全有效的,具有减少手术时间及出血,促进患者康复的优势。Objective To explore the safety and effectiveness of laparoscopic transabdominal preperitoneal herniorrhaphy(TAPP)in the treatment of incarcerated femoral hernia.Methods Retrospectively analysed the clinical data of 30 patients with incarcerated femoral hernia admitted to the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from April 2017 to December 2021.According to the surgical method,they were divided into 17 cases in the laparoscopic group and 13 cases in the open groups,and the indicators of surgery,hospital stay,complications and follow-up results were compared between the two groups.Results Surgical time,intraoperative bleeding and hospital days were shorter in the laparoscopic group than in the open group[(71.35±10.48)min vs(86.90±12.54)min,P=0.010;(17.06±3.40)mL vs(33.69±6.55)mL,P<0.010;(5.90±1.30)d vs(8.23±9.93)d,P<0.010],and postoperative pain scores were lower than in the open group[(1.12±0.33)vs(2.09±0.70),P<0.010],and postoperative ventilation time was shorter than in the open group[(14.82±4.20)h vs(21.64±3.17)h,P<0.010],and the differences were statistically significant;there was no statistical difference in postoperative complications between the two groups,and none of them recurred in the 1-year postoperative follow-up results.Conclusion TAPP surgery for incarcerated femoral hernia is safe and effective,with the advantages of reducing operative time and bleeding,and promoting patient recovery.

关 键 词：腹腔镜 经腹腹膜前无张力疝修补术 股疝 嵌顿 

分 类 号：R657.8[医药卫生—外科学]