改良完全腹膜外腹腔镜腹股沟疝修补术、经腹腔腹膜前腹腔镜疝修补术与Rutkow术式治疗腹股沟疝的疗效对比  

Comparison of the Efficacy of Modified Total Extraperitoneal Prosthesis,Transabdominal Preperitoneal Prosthetic and Rutkow Repair in the Treat⁃ment of Inguinal Hernia

作　　者：欧庆华 OU Qinghua(Second Department of Surgery,Fujian Energy General Hospital,Fuzhou,Fujian,350001,China)

机构地区：[1]福建省福能集团总医院外二科,福建福州350001

出　　处：《中外医疗》2024年第34期29-32,共4页China & Foreign Medical Treatment

摘　　要：目的比较腹股沟疝治疗中使用改良完全腹膜外腹腔镜腹股沟疝修补术(total-extraperitoneal-prosthesis,TEP)、经腹腔腹膜前腹腔镜疝修补术(transabdominal preperitoneal prosthesis,TAPP)与疝环充填式无张力修补术(Rutkow inguinal rapair,Rutkow)的疗效。方法方便选取2021年8月—2022年8月福建省福能集团总医院外二科收治的腹股沟疝患者75例为研究对象,依据不同手术方法分为TEP组、TAPP组和Rutkow组,每组25例。对比3组患者治疗前、后的炎性因子[C反应蛋白(C-reactive protein,CRP)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(interleuke-6,IL-6)]水平、手术一般情况(住院时间、术中出血、切口长度)以及并发症发生率。结果Rutkow组手术时间短于TEP组、TAPP组,TEP组切口长度短于TAPP组、Rutkow组,术中出血量少于TAPP组、Rutkow组,差异均有统计学意义(P均<0.05)。TEP组并发症总发生率为4.00%(1/25),低于TAPP组的24.00%(6/25)、Rutkow组的28.00%(7/25),差异有统计学意义(χ^(2)=4.153,5.357;P均<0.05)。治疗前,3组患者炎性因子水平比较,差异无统计学意义(P>0.05);治疗后,TEP组CRP、TNF-α、IL-6水平低于TAPP组、Rutkow组,差异均有统计学意义(P均<0.05)。结论TEP术后并发症发生率及炎性因子水平均优于TAPP、Rutkow;因此,临床治疗腹股沟疝患者采用TEP治疗效果较好。Objective To compare the efficacy of total-extraperitoneal-prosthesis(TEP),transabdominal preperitoneal prosthesis(TAPP)and Rutkow inguinal rapair(Rutkow)in inguinal hernia.Methods A total of 75 patients with ingui-nal hernia admitted to the Second Department of Surgery in Fujian Energy General Hospital from August 2021 to Au-gust 2022 were conveniently selected as the study objects and divided into TEP group,TAPP group and Rutkow group according to different surgical methods,with 25 cases in each group.The levels of inflammatory factors[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)],general surgical conditions(hospitalization time,intraoperative bleeding,incision length)and complication rate of the 3 groups were compared before and after treatment.Results The operative time of Rutkow group was shorter than that of TEP group and TAPP group,the inci-sion length of TEP group was shorter than that of Rutkow group,and the intraoperative blood loss in the TEP group was less than that of TAPP group and Rutkow group,the differences were statistically significant(all P<0.05).The to-tal incidence of complications in TEP group was 4.00%(1/25),which was lower than that in TAPP group 24.00%(6/25)and Rutkow group 28.00%(7/25),the difference was statistically significant(χ^(2)=4.153,5.357;both P<0.05).Be-fore treatment,there was no significant difference in the levels of inflammatory factors among 3 groups(P>0.05).After treatment,the level of CRP,TNF-αand IL-6 in TEP group were lower than those in TAPP group and Rutkow group,the differences were statistically significant(all P<0.05).Conclusion The incidence of postoperative complications and the level of inflammatory factors of TEP were better than those of TAPP and Rutkow.Therefore,the clinical treat-ment of inguinal hernia patients with TEP treatment effect is better.

关 键 词：改良完全腹膜外腹腔镜腹股沟疝修补术 经腹腔腹膜前腹腔镜疝修补术 Rutkow术 腹股沟疝 疗效 

分 类 号：R656.21[医药卫生—外科学]