T型切开离断疝囊结合可吸收线缝合固定对腹股沟疝患者TAPP术后血清肿的影响  

Effect of T-shaped Incision of Hernia Sac Combined with Absorbable Suture Fixation on Seroma after TAPP in Patients with Inguinal Hernia

作　　者：荆克杰 甘雪思 黎淑君 阮广源 于峰 JING Kejie;GAN Xuesi;LI Shujun;RUAN Guangyuan;YU Feng(Leliu Hospital Affiliated to Shunde Hospital of Guangzhou University of Traditional Chinese Medicine(Foshan Shunde District Leliu Hospital),Foshan,Guangdong,528000,China)

机构地区：[1]广州中医药大学顺德医院附属勒流医院(佛山市顺德区勒流医院),广东佛山528000

出　　处：《中外医疗》2025年第7期39-42,47,共5页China & Foreign Medical Treatment

基　　金：佛山市卫生健康局医学科研课题项目(20220354)。

摘　　要：目的探讨T型切开离断疝囊结合可吸收线缝合固定对腹股沟疝患者腹腔镜下经腹腹膜前疝修补术(transabdominal preperitoneal prosthesis,TAPP)术后血清肿的影响。方法随机选取2022年1月—2024年3月广州中医药大学顺德医院附属勒流医院(佛山市顺德区勒流医院)收治的120例行TAPP术治疗的男性腹股沟疝患者为研究对象,根据疝囊大小分为甲组(疝囊直径≥5 cm,60例)与乙组(疝囊直径<5 cm,60例),每组再按补片固定方式的不同分为可吸收线缝合固定组(甲组记为A1、乙组记为A2)、免缝合固定组(甲组记为B1、乙组记为B2)与钛钉固定组(甲组记为C1、乙组记为C2)3个亚组,各20例。比较各组手术指标、血清肿发生率及疼痛程度。结果乙组各亚组疝囊处置时间、手术时间及术中出血量均优于甲组对应亚组,差异均有统计学意义(P均<0.05)。甲、乙两组各自组内3个亚组疝囊处置时间比较,差异均无统计学意义(P均>0.05)。A1组手术时间长于B1与C1组,A2组手术时间长于B2与C2组,差异均有统计学意义(P均<0.05)。甲组与乙组组内各亚组血清肿发生率比较,差异均无统计学意义(P均>0.05)。乙组各亚组血清肿发生率均低于甲组对应亚组,差异均有统计学意义(P均<0.05)。A1组疼痛评分为(2.51±0.75)分,B1组疼痛评分为(2.72±0.67)分,均低于C1组的(3.45±0.83)分,A2组的疼痛评分为(1.76±0.36)分,B2组疼痛评分为(1.95±0.44)分,均低于C2组的(2.49±0.58)分,差异均有统计学意义(F=11.630,13.050;P均<0.05)。乙组各亚组疼痛评分均低于甲组对应亚组,差异均有统计学意义(P均<0.05)。结论在腹股沟疝患者TAPP术中,疝囊直径<5 cm的疝囊处置时间、手术时间、术中出血量均优于疝囊直径>5 cm者,术后血清肿发生率较低。与免缝合固定与钛钉固定相比,可吸收线缝合固定补片的手术时间更长,但患者术后疼痛程度更低,不同固定方法对血清肿发生无较大影�Objective To investigate the effect of T-shaped incision hernia sac combined with absorbable suture fixation on seroma after transabdominal preperitoneal prosthesis(TAPP)in patients with inguinal hernia.Methods From January 2022 to March 2024,120 male patients with inguinal hernia treated by TAPP in Leliu Hospital Affiliated to Shunde Hospital of Guangzhou University of Traditional Chinese Medicine(Foshan Shunde District Leliu Hospital)were randomly selected as the research objects.According to the size of hernia sac,they were divided into group A(diameter of hernia sac≥5 cm,60 cases)and group B(diameter of hernia sac<5 cm,60 cases).Each group was divided into three subgroups according to different patch fixation methods:absorbable suture fixation group(group A was recorded as A1 and group B was recorded as A2),suture-free fixation group(group A was recorded as B1 and group B was recorded as B2)and titanium nail fixation group(group A was recorded as C1 and group B was recorded as C2),with 20 cases in each group.The surgical indicators,the incidence of seroma and the degree of pain were compared among the groups.Results The hernia sac disposal time,operation time and intraoperative blood loss in each subgroup of group B were better than those in the corresponding subgroup of group A,and the differences were statistically significant(all P<0.05).There was no significant difference in the treatment time of hernia sac among the three subgroups of group A and group B(all P>0.05).The operation time of group A1 was longer than that of group B1 and group C1,and the operation time of group A2 was longer than that of group B2 and group C2,and the differences were statistically significant(all P<0.05).There was no significant difference in the incidence of seroma between the subgroups in group A and group B(both P<0.05).The incidence of seroma in each subgroup of group B was lower than that in the corresponding subgroup of group A,and the differences were statistically significant(all P<0.05).The pain score of group A1 w

关 键 词：腹股沟疝 T型切开离断 固定 可吸收线 疝囊 

分 类 号：R656.21[医药卫生—外科学]