透壁缝合法在日间腹腔镜疝修补术中固定直疝假性疝囊的效果  

Effect of through wall suture method in fixing the pseudo hernia sac of direct hernia during daytime laparoscopic hernia repair surgery

作　　者：李松 夏阿东 陈国梁[1] LI Song;XIA Adong;CHEN Guoliang(Department of Hepatobilary Pancreatic Gastrointestinal Surgery,Jinhua People's Hospital,Zhejiang Province,Jinhua321000,China)

机构地区：[1]浙江省金华市人民医院肝胆胰胃肠外科,浙江金华321000

出　　处：《中国当代医药》2024年第27期71-75,共5页China Modern Medicine

摘　　要：目的探讨透壁缝合法在日间腹腔镜疝修补术中固定直疝假性疝囊预防术后血肿的临床价值。方法选取2021年6月至2022年10月就诊于金华市人民医院行日间腔镜腹股沟直疝修补手术的81例男性患者作为研究对象,按照随机数字表法分为对照组(40例)与观察组(41例)。观察组患者采用透壁缝合法固定直疝假性疝囊,对照组患者术中使用钉枪法关闭假性疝囊。比较两组手术相关指标、术后2个月内血清肿的发生情况、相关并发症及术后1年内疝复发的发生情况。结果观察组Ⅱ型疝患者手术时间短于Ⅲ型疝患者,差异有统计学意义(P<0.05),Ⅱ型疝、Ⅲ型疝患者出血量、术后疼痛评分比较,差异无统计学意义(P>0.05)。观察组患者术后第1、7天VAS评分、总费用均低于对照组,差异有统计学意义(P<0.05)。观察组血清肿发生率低于对照组,差异有统计学意义(P<0.05)。观察组并发症总发生率低于对照组,差异有统计学意义(P<0.05),术后1年内两组疝复发率比较,差异无统计学意义(P>0.05)。结论日间腹股沟直疝修补术中使用透壁缝合法固定直疝假性疝囊对术后血清肿发生有预防作用,不仅患者疼痛程度减轻,医疗费用及围手术期相关并发症发生率也有所降低,可以促进患者康复,有利于日间疝的发展。Objective To investigate the clinical value of transmural suture in preventing postoperative hematoma by fixing the pseudo hernia sac of direct hernia during daytime laparoscopic hernia repair.Methods A total of 81 male patients undergoing endoscopic repair of direct inguinal hernia treated in Jinhua People's Hospital from June 2021 to October 2022 were selected as the study objects.They were divided into control group(40 cases)and observation group(41 cases)according to random number table method.The pseudo hernia sac in the observation group was fixed by transmural suture,while the pseudo hernia sac was closed by nail gun in the control group.The postoperative indexes,occurrence of seroma within 2 months after surgery,related complications and recurrence of hernia within 1 year after surgery were compared between the two groups.Results The operation time of typeⅡhernia patients in the observation group was shorter than that of typeⅢhernia patients,and the difference was statistically significant(P<0.05),while the blood loss and postoperative pain score of typeⅡhernia patients and typeⅢhernia patients were not statistically significant(P>0.05).The VAS score and total cost of observation group were lower than those of the control group at the 1st and 7th day after surgery,with statistical significances(P<0.05).The incidence of serum swelling in observation group was lower than that in control group,and the difference was statistically significant(P<0.05).The total incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).There was no statistically significant difference in the recurrence rate of hernia between the two groups within 1 year after surgery(P>0.05).Conclusion The use of transmural suture to fix the pseudo hernia sac in the daytime repair of direct inguinal hernia can prevent the occurrence of postoperative seroma,reduce the degree of pain,reduce the medical cost and the incidence of perioperative complicati

关 键 词：腹股沟直疝 血清肿 日间疝 腹腔腹直疝修补术 透壁缝合法 

分 类 号：R459.9[医药卫生—治疗学]