腹腔镜下不同术式和开放手术疝修补术对腹股沟疝的治疗效果研究  

Study on therapeutic effect of different laparoscopic and open surgical hernia repair on inguinal hernia

作　　者：聂立煌 NIE Li-huang(Department of General Surgery,Nanchang Xinjian District Hospital of Traditional Chinese Medicine,Nanchang 330100,China)

机构地区：[1]南昌市新建区中医医院普外科,330100

出　　处：《中国实用医药》2025年第7期49-52,共4页China Practical Medicine

摘　　要：目的探讨腹腔镜下不同术式[腹腔镜全腹膜外疝修补术(TEP)和腹腔镜经腹腹膜前疝修补术(TAPP)]和开放手术疝修补术对腹股沟疝的治疗效果。方法选取180例腹股沟疝患者,按照手术方式不同分为A组、B组、C组,各60例。A组实施开放手术疝修补术,B组实施腹腔镜全腹膜外疝修补术,C组实施腹腔镜经腹腹膜前疝修补术。对比三组手术相关指标、复发情况、术后疼痛评分、术区麻木感评分及并发症发生情况。结果B组和C组的手术时间、疼痛持续时间、下地活动时间、住院时间分别为(48.26±9.37)min、(32.38±7.49)h、(72.51±8.93)h、(7.17±0.97)d和(47.39±8.96)min、(33.26±7.13)h、(70.32±8.59)h、(7.29±0.87)d,均比A组的(68.08±10.74)min、(53.36±8.91)h、(97.65±10.28)h、(9.45±1.84)d更短(P<0.05);B组和C组的手术时间、疼痛持续时间、下地活动时间、住院时间对比没有明显差异(P>0.05)。B组和C组的复发率、术后疼痛评分以及术区麻木感占比分别为3.3%、(1.23±0.67)分、6.7%和3.3%、(1.25±0.53)分、5.0%,均比A组的13.3%、(3.63±0.43)分、16.7%更低(P<0.05);B组和C组复发率、术后疼痛评分以及术区麻木感占比对比没有明显差异(P>0.05)。B组和C组并发症发生率分别为11.7%、10.0%,均比A组的36.7%更低(P<0.05);B组和C组并发症发生率对比没有明显差异(P>0.05)。结论相比开放手术疝修补术,腹腔镜手术(腹腔镜全腹膜外疝修补术和腹腔镜经腹腹膜前疝修补术)治疗腹股沟疝术后疼痛程度和麻木感较轻,并发症少,康复时间短,临床可以根据患者的具体病情选择合适的腹腔镜手术方式。Objective To explore the therapeutic effect of different laparoscopic hernia repair[laparoscopic total extraperitoneal hernia repair(TEP)and laparoscopic transabdominal preperitoneal hernia repair(TAPP)]and open surgical hernia repair on inguinal hernia.Methods A total of 180 patients with inguinal hernia were selected and divided into group A,group B and group C according to different surgical methods,each with 60 cases.Group A underwent open surgery for hernia repair,group B underwent laparoscopic total extraperitoneal hernia repair,and group C underwent laparoscopic transabdominal preperitoneal hernia repair.The surgery-related indexes,recurrence,postoperative pain score,numbness score in the surgical area and complications were compared among the three groups.Results The operation time,pain duration,off-bed ambulation time and hospitalization time of group B and group C were(48.26±9.37)min,(32.38±7.49)h,(72.51±8.93)h,(7.17±0.97)d and(47.39±8.96)min,(33.26±7.13)h,(70.32±8.59)h,(7.29±0.87)d,which were shorter than(68.08±10.74)min,(53.36±8.91)h,(97.65±10.28)h,(9.45±1.84)d in group A(P<0.05).There were no significant differences in operation time,pain duration,off-bed ambulation time and hospitalization time between group B and group C(P>0.05).The recurrence rate,postoperative pain score and percentage of numbness in the operative area were 3.3%,(1.23±0.67)points,6.7%,3.3%,(1.25±0.53)points and 5.0%in group B and group C,which were lower than 13.3%,(3.63±0.43)points and 16.7%in group A(P<0.05).There were no significant differences in the recurrence rate,postoperative pain score and the percentage of numbness in the operative area between group B and group C(P>0.05).The incidence of complications in group B and group C were 11.7%and 10.0%,which were lower than 36.7%in group A(P<0.05).There was no significant difference in the incidence of complications between group B and group C(P>0.05).Conclusion Compared with open surgery for hernia repair,laparoscopic surgery(laparoscopic total extraperitoneal h

关 键 词：腹股沟疝 腹腔镜全腹膜外疝修补术 腹腔镜经腹腹膜前疝修补术 开放手术疝修补术 

分 类 号：R656.2[医药卫生—外科学]