腹腔镜下经腹膜前修补与完全腹膜外修补在腹股沟疝中的应用  

Application of Laparoscopic Transabdominal Preperitoneal Repair and Total Extraperitoneal Repairin Adult Inguinal Hernia and Its Effecton Inflammation and Pain

作　　者：张贤文 ZHANG Xianwen(Department of Gastroenterology,Second Affiliated Hospital of Xiamen Medical College,Xiamen,Fujian,361000,China)

机构地区：[1]厦门医学院附属第二医院胃肠外科,福建厦门361000

出　　处：《中外医疗》2025年第5期49-52,共4页China & Foreign Medical Treatment

摘　　要：目的研讨腹腔镜下经腹膜前修补(laparoscopic transabdominal preperitoneal repair,TAPP)术式与腹腔镜下完全腹膜外修补(total extraperitoneal repair,TEP)术式在成人腹股沟疝中的应用及对患者机体炎症、疼痛的影响。方法研究时间2023年2月—2024年2月,方便选取227例成人腹股沟疝患者,均为厦门医学院附属第二医院收治,分组依据不同术式,即对照组(105例)和观察组(122例)。对照组行TAPP术式,观察组行TEP术式,比较两组手术基础指标、机体炎症、疼痛状况以及并发症发生情况。结果相较于对照组,观察组手术时间长,术中出血量少,术后排气时间、住院时间短,差异均有统计学意义(P均<0.05)。与对照组对比,观察组术后24 h的炎症水平较低、术后疼痛持续时间缩短、疼痛程度降低,差异均有统计学意义(P均<0.05)。观察组并发症总发生率3.28%(4/122),相较于对照组的10.48%(11/105)更低,差异有统计学意义(χ^(2)=4.737,P<0.05)。结论与TAPP术式相比,TEP术式会延长成人腹股沟疝患者的手术时间,但术中出血较少,术后康复较快,机体炎症反应及疼痛状况较轻,并发症较少。Objective To investigate the application of laparoscopic transabdominal preperitoneal repair(TAPP)and laparoscopic total extraperitoneal repair(TEP)in adult inguinal hernia and their effects on inflammation and pain in patients.Methods The research period is from February 2023 to February 2024.A total of 227 adult patients with inguinal hernia were conveniently selected,all of whom were admitted to the Second Affiliated Hospital of Xiamen Medical College.They were divided into two groups based on different surgical procedures,namely the control group(105 cases)and the observation group(122 cases).The control group was treated with TAPP,and the observation group was treated with TEP.The basic indexes,body inflammation,pain status and complications of the two groups were compared.Results Compared with the control group,the operation time of the observation group was longer,the intraoperative blood loss was less,the postoperative exhaust time and hospitalization time were shorter,and the differences were statistically significant(all P<0.05).Compared with the control group,the inflammation level at 24 h after operation in the observation group was lower,the duration of post-pain was shortened,and the degree of pain was reduced,and the differences were statistically significant(all P<0.05).The total incidence of complications in the observation group was 3.28%(4/122),lower than that in the control group 10.48%(11/105),and the difference was statistically significant(χ^(2)=4.737,P<0.05).Conclusion Compared with TAPP,TEP can prolong the operation time of adult inguinal hernia patients,but it has less intraoperative bleeding,faster postoperative recovery,less inflammatory response and pain,and fewer complications.

关 键 词：成人腹股沟疝 腹腔镜下经腹膜前修补术式 完全腹膜外修补术式 机体炎症 疼痛 

分 类 号：R657.8[医药卫生—外科学]