腹腔镜经腹腹膜前修补术与Lichtenstein手术对腹股沟疝患者术后早期疼痛和行动力的影响  

Effects of laparoscopic transabdominal preperitoneal repair and Lichtenstein surgery on postoperative early pain and mobility in patients with inguinal hernia

作　　者：仝聪[1] 陈曦 周哲琦 王慧 张晓龙 赵旭 阎立昆[1] Tong Cong;Chen Xi;Zhou Zheqi;Wang Hui;Zhang Xiaolong;Zhao Xu;Yan Likun(First Department of General Surgery,Shaanxi Provincial People's Hospital,Xi'an 710068,China)

机构地区：[1]陕西省人民医院普通外科一科,西安710068

出　　处：《中华消化外科杂志》2024年第12期1530-1537,共8页Chinese Journal of Digestive Surgery

基　　金：陕西省科技厅创新能力支撑计划‑科技创新团队(2020TD‑048)。

摘　　要：目的探讨腹腔镜经腹腹膜前修补术(TAPP)与Lichtenstein手术对腹股沟疝患者术后早期疼痛和行动力的影响。方法采用回顾性队列研究方法。收集2021年6月至2022年12月陕西省人民医院收治的184例单侧腹股沟疝患者的临床资料;男152例,女32例;年龄为(64±8)岁。184例患者中,92例行TAPP,设为TAPP组;92例行Lichtenstein手术,设为Lichtenstein组。观察指标:(1)手术情况。(2)术后疼痛情况。(3)术后行动力。正态分布的计量资料组间比较采用独立样本t检验;同组自身前后对照采用配对样本t检验。偏态分布的计量资料组间比较采用Mann‑Whitney U检验。计数资料组间比较采用χ²检验。结果(1)手术情况。TAPP组和Lichtenstein组患者总住院时间分别为1.70(1.00,2.00)d和2.12(2.00,3.00)d、术后住院时间分别为1.00(1.00,1.00)d和1.42(1.00,2.00)d、住院费用分别为14808(14385,15292)元和10590(9802,11362)元,两组患者上述指标比较,差异均有统计学意义(Z=-3.23、-4.07、-11.72,P<0.05)。(2)术后疼痛情况。TAPP组和Lichtenstein组患者术前口述分级评分分别为(1.36±0.75)分和(1.34±0.80)分、术后20~22 h口述分级评分分别为(3.22±0.66)分和(3.42±0.80)分,两组患者组内术前及术后20~22 h口述分级评分比较,差异均有统计学意义(t=-29.15、-31.46,P<0.05)。(3)术后行动力。TAPP组和Lichtenstein组患者术前起床至站立床旁时间分别为(5.47±1.08)s和(5.87±1.13)s、术后20~22 h起床至站立床旁时间分别为(7.94±2.23)s和(11.59±1.88)s,两组患者组间术后20~22 h、两组组内术前及术后20~22 h起床至站立床旁时间比较,差异均有统计学意义(t=-11.99、-15.64、-27.26,P<0.05)。TAPP组和Lichtenstein组患者术前屈膝屈髋90°时间分别为(0.74±0.32)s和(0.81±0.19)s、术后20~22 h屈膝屈髋90°时间分别为(1.23±0.54)s和(1.97±0.69)s,两组患者组间术后20~22 h、两组组内术前及术后20~22 h屈膝屈髋90°时间比较,差异均有统�Objective To investigate the effects of laparoscopic transabdominal preperitoneal repair(TAPP)and Lichtenstein surgery on postoperative early pain and mobility in patients with inguinal hernia.Methods The retrospective cohort study was conducted.The clinical data of 184 patients with unilateral inguinal hernia who were admitted to Shaanxi Provincial People's Hospital from June 2021 to December 2022 were collected.There were 152 males and 32 females,aged(64±8)years.Of the 184 patients,92 cases undergoing TAPP were divided into the TAPP group,and 92 cases undergoing Lichtenstein surgery were divided into the Lichtenstein group.Observation indicators:(1)surgical situations;(2)postoperative pain;(3)postoperative mobility.Comparison of measurement data with normal distribution between groups was conducted using the independent sample t test.Paired sample t test was used for comparison within group before and after surgery.Comparison of measurement data with skewed distribution between groups was conducted using the Mann‐Whitney U test.Comparison of count data between groups was conducted using the chi-square test.Results(1)Surgical situations.Total duration of hospital stay,duration of postoperative hospital stay,expense of hospitalization were 1.70(1.00,2.00)days,1.00(1.00,1.00)days,14808(14385,15292)yuan in the TAPP group,versus 2.12(2.00,3.00)days,1.42(1.00,2.00)days,10590(9802,11362)yuan in the Lichtenstein group,showing significant differences in the above indicators between the two groups(Z=−3.23,−4.07,−11.72,P<0.05).(2)Postoperative pain.Score of verbal rating scale(VRS)were 1.36±0.75 and 3.22±0.66 before surgery and at 20−22 hours after surgery in the TAPP group,versus 1.34±0.80 and 3.42±0.80 in the Lichtenstein group,showing significant differences within the two groups(t=−29.15,−31.46,P<0.05).(3)Postoperative mobility.The time from getting up to standing bedside of patients before surgery and at 20−22 hours after surgery were(5.47±1.08)seconds and(7.94±2.23)seconds in the TAPP group,ve

关 键 词：腹股沟疝 腹腔镜经腹腹膜前修补术 李金斯坦法修补术 行动力 疼痛 疗效 手术 

分 类 号：R656.21[医药卫生—外科学]