摘要
目的观察腹腔镜下全腹膜外与经正中线切口腹膜前腹股沟疝修补术的疗效。方法选取2018年3月~2019年3月我院治疗的98例腹股沟疝修患者为研究对象,采用随机数字表法分为对照组和观察组,各49例。对照组采用经正中线切口腹膜前腹股沟疝修补术治疗,观察组采用腹腔镜下全腹膜外修补术治疗,比较两组手术指标(手术时间、术中出血量、肛门排气时间、下床活动时间、住院时间、住院费用)、不同时间段(术后1天、1、3、5个月)疼痛(VAS)评分、并发症发生情况以及复发率。结果观察组手术时间、住院费用均大于对照组,术中出血量、肛门排气时间、下床活动时间、住院时间均小于对照组,差异有统计学意义(P<0.05);观察组术后1天、1、3个月VAS评分均低于对照组(P<0.05),术后5个月低于对照组,但差异无统计学意义(P>0.05);观察组并发症发生率为4.08%,低于对照组的10.20%,差异有统计学意义(P<0.05);随访6个月,观察组复发率为2.04%,与对照组的4.08%比较,差异无统计学意义(P>0.05)。结论经正中线切口腹膜前腹股沟疝修补术在手术时间和住院费用方面具有优势,虽然腹腔镜下全腹膜外手术时间长,住院费用大,但术中出血量少,术后胃肠和下床活动时间段,术后疼痛评分低,并发症少,利于患者的康复,具有临床应用的重要价值。
Objective To observe the efficacy of laparoscopic total extraperitoneal and preperitoneal inguinal hernia repair through midline incision.Methods A total of 98 patients with inguinal hernia repaired in our hospital from March 2018 to March 2019 were selected as the research objects,and they were divided into control group and observation group by random number table method,with 49 cases in each group.The control group was treated with preperitoneal inguinal hernia repair through a midline incision,and the observation group was treated with laparoscopic total epiperitoneal repair.The two groups were compared with surgical indicators(operation time,intraoperative blood loss,anal exhaust time,out of bed activity)time,length of hospitalization,hospitalization expenses,pain(VAS)scores at different time periods(1 day,1,3,and 5 months after surgery),occurrence of complications,and recurrence rate.Results The operation time and hospitalization cost of the observation group were greater than those of the control group.The intraoperative blood loss,anal exhaust time,time to get out of bed,and hospitalization time were all less than those of the control group,the difference was statistically significant(P<0.05);The VAS scores at 1 day,1,and 3 months were lower than those of the control group(P<0.05),and 5 months after the operation,they were lower than the control group,but the difference was not statistically significant(P>0.05);the incidence of complications in the observation group was 4.08%,lower than 10.20% of the control group,the difference was statistically significant(P<0.05);follow-up for 6 months,the recurrence rate of the observation group was 2.04%,compared with 4.08% of the control group,the difference was not statistically significant(P>0.05).Conclusion Preperitoneal inguinal hernia repair through midline incision has advantages in terms of operation time and hospitalization costs.Although total extraperitoneal surgery under laparoscopic surgery takes a long time and the hospitalization costs are high,the amount of intraoperative blood loss is small,and the gastrointestinal and out-of-bed after surgery during the active period,the postoperative pain score is low and the complications are few,which is conducive to the rehabilitation of patients and has important clinical application value.
作者
付艳伟
张睿
FU Yan-wei;ZHANG Rui(Department of Surgery,Tianjin Port Hospital,Tianjin 300450,China;Department of Hepatobiliary Surgery,Xiangcheng People's Hospital,Suzhou 215131,Jiangsu,China)
出处
《医学信息》
2020年第24期119-121,共3页
Journal of Medical Information
关键词
腹腔镜
全腹膜外
腹股沟疝
疝修补术
Laparoscopy
Total extraperitoneal
Inguinal hernia
Hernia repair
