腹腔镜全腹膜外腹股沟疝修补术在治疗急性绞窄性腹股沟疝中的应用分析  

Application of laparoscopic total extraperitoneal inguinal hernia repair in the treatment of acute strangulated inguinal hernia

作　　者：聂双发[1] 王辰洋 胡晓峰[1] 李磊[1] 王韬[1] 王晓旭 宋永 费建东[1] 安永铸[1] Nie Shuang-fa;Wang Chen-yang;Hu Xiao-feng;Li Lei;Wang Tao;Wang Xiao-xu;Song Yong;Fei Jian-dong;An Yong-zhu(Department of General Surgery,The First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei,China)

机构地区：[1]河北北方学院附属第一医院普通外科,河北张家口075000

出　　处：《四川生理科学杂志》2024年第8期1677-1680,共4页

基　　金：河北省卫生健康委员会医学科研课题计划项目(20200553)。

摘　　要：目的:探讨腹腔镜全腹膜外腹股沟疝修补术(Total extraperitoneal repair inguinal hernia repair,TEP)在急性绞窄性腹股沟疝应用价值分析。方法:选取2018年1月至2023年12月于我院诊断为急性绞窄性腹股沟疝的58例患者作为研究对象,随机分为腹腔镜组和开腹组,各29例。比较两组患者围手术期实验室检查指标、手术时间、术后排气时间、术后并发症发生率、术后引流管拔除时间、住院时间等指标。结果:术后第3 d,两组白细胞(White blood cells,WBC)、尿素氮(Urea nitrogen,BUN)、肌酐(Creatinine,Cr)、C反应蛋白(C-reactive protein,CRP)均明显下降,且腹腔镜组明显低于开腹组(P<0.05);白蛋白(Albumin,ALB)水平均明显升高,且腹腔镜组明显高于开腹组(P<0.05);腹腔镜组在术中出血量、术后排气时间、术后进食时间、引流管拔除时间、住院时间均明显少于开腹组(P<0.05);两组手术时间无明显差异(P>0.05);腹腔镜组的肺部感染、伤口感染的发生率明显低于开腹组(P<0.05)。结论:腹腔镜全腹膜外腹股沟疝修补术对治疗急诊绞窄性腹股沟疝是安全的、可行的,较开放手术有一定的优势。Objective:To explore the application value of total extraperitoneal repair(TEP)in acute strangulated inguinal hernia.Methods:A total of 58 patients diagnosed with acute strangulated inguinal hernia in our hospital from January 2018 to December 2023 were selected.They were randomly divided into a laparoscopic group and conventional resection group,with 29 cases in each group.Perioperative laboratory examination indicators,surgical time,postoperative exhaust time,incidence of postoperative complications,postoperative drainage tube removal time,and hospital stay between two groups were compared.Results:On the third day after surgery,white blood cells(WBC),urea nitrogen(BUN),creatinine(Cr),and C-reactive protein(CRP)were obviously decreased in both groups,and the laparoscopic group showed a significant decrease compared to the conventional resections group,which was of statistical significance(P<0.05).Albumin(ALB)levels were increased compared to the first day after surgery,while the laparoscopic group showed a significant increase compared to the conventional resections group,which showed a statistically significant difference(P<0.05);The intraoperative bleeding,postoperative exhaust time,postoperative feeding time,drainage tube removal time,and hospital stay in the laparoscopic group were significantly lower than the conventional resection group(P<0.05),and there was no significant difference in surgical time between the two groups(P>0.05);The incidence of lung and wound infections in the conventional resection group was significantly higher than that in the laparoscopic group(P<0.05).Conclusion:Laparoscopic total extraperitoneal inguinal hernia repair is safe and feasible for the treatment of emergency strangulated inguinal hernia,and has certain advantages over conventional resection surgery.

关 键 词：绞窄性腹股沟疝 腹腔镜全腹膜外腹股沟疝修补术 肠切除肠吻合 

分 类 号：R656.21[医药卫生—外科学]