腹腔镜经腹腹膜前疝修补术与开放式腹膜前无张力疝修补术的应用效果比较  

Comparison of the application eff ects of laparoscopic transabdominal preperitoneal prosthesis and open tension-free anterior peritoneal hernia repair

作　　者：周坤林 Zhou Kunlin(Department of General Surgery,Xiangcheng District Second People’s Hospital,Jiangsu Suzhou 215100,China)

机构地区：[1]苏州市相城区第二人民医院普外科,江苏苏州215100

出　　处：《临床普外科电子杂志》2025年第1期78-81,共4页Journal of General Surgery for Clinicians(Electronic Version)

摘　　要：目的探讨腹腔镜经腹腹膜前疝修补术(transabdominal preperitoneal prosthesis,TAPP)与开放式腹膜前无张力疝修补术治疗腹股沟疝的效果。方法选择2022年1月至2024年10月苏州市相城区第二人民医院收治的腹股沟疝患者80例进行研究,根据手术方法分为对照组和观察组,各40例。对照组采取开放式腹膜前无张力疝修补术治疗,观察组采取腹腔镜TAPP治疗,比较两组患者的围手术期炎症反应指标、术后恢复情况及并发症发生情况。结果术后1d,两组血清C反应蛋白、降钙素原、中性粒细胞百分比明显升高,而观察组显著低于对照组(P<0.01)。观察组患者的肠鸣音恢复时间、肛门排气时间、自主活动时间、住院时间均短于对照组,且术后12h、24h、48h的疼痛程度轻于对照组,差异均有显著性(P<0.001)。观察组并发症发生率(5.00%)显著低于对照组(22.50%)(χ^(2)=5.165,P=0.023)。结论与开放式腹膜前无张力疝修补术相比,腹腔镜TAPP治疗腹股沟疝更具有优势,促使患者术后快速恢复,减轻机体炎症反应和早期疼痛程度,减少术后并发症。Objective To investigate the efficacy of laparoscopic transabdominal preperitoneal prosthesis(TAPP)and open pre peritoneal tension-free hernia repair in the treatment of inguinal hernia.Method 80 patients with inguinal hernia admitted to the Second People’s Hospital of Xiangcheng District in Suzhou City from January 2022 to October 2024 were selected for the study.They were divided into two groups of 40 patients each ac-cording to the surgical method.The control group received open peritoneal tension-free hernia repair surgery,while the observation group received laparoscopic TAPP treatment.The perioperative infl ammatory response indicators,postoperative recovery,and incidence of complications were compared between the two groups of patients.Result On postoperative day 1,serum C-reactive protein,procalcitonin,and neutrophil percentage signifi cantly increased in both groups,while the observation group was signifi cantly lower than the control group(P<0.01).The recov-ery time of bowel sounds,anal exhaust time,spontaneous activity time,and hospitalization time of the observation group patients were shorter than those of the control group,and the pain level at 12 hours,24 hours,and 48 hours after surgery was milder than that of the control group,with signifi cant diff erences(P<0.001).The incidence of complications in the observation group(5.00%)was signifi cantly lower than that in the control group(22.50%)(χ^(2)=5.165,P=0.023).Conclusion Compared with open retroperitoneal tension-free hernia repair,laparoscopic TAPP has more advantages in treating inguinal hernia,promoting rapid postoperative recovery,reducing infl amma-tion and early pain,and minimizing postoperative complications.

关 键 词：腹股沟疝 腹腔镜经腹腹膜前疝修补术 无张力疝修补术 炎症反应 并发症 

分 类 号：R65[医药卫生—外科学]