2019 年第 12 期 第 14 卷

腹腔镜下经腹腹膜前疝无张力修补术与传统术式治疗腹股沟疝患者近期效果比较

Short-term effects of laparoscopic transperitoneal tension-free repair and traditional operation on inguinal hernia

作者：傅厚丰符敏杨河孙长河胡军

英文作者：

单位：571400海南省琼海市人民医院普外科

英文单位：

关键词：腹股沟疝；腹腔镜；无张力修补术

英文关键词：

• 摘要：

• 【摘要】目的    观察腹腔镜下经腹腹膜前疝无张力修补术与传统术式治疗腹股沟疝的效果。方法    选取2015年1月至2016年1月海南省琼海市人民医院收治的100例腹股沟疝患者，按照治疗方法的不同分为腹腔镜组（50例）和开放组（50例），腹腔镜组采用腹腔镜下经腹腹膜前疝无张力修补术治疗，开放组采用开放式无张力疝修补术治疗。比较2组手术时间、术中失血量、术后下床活动、肠胃功能恢复时间、术后住院时间、住院费用、术后24 h及1周疼痛评分、并发症及复发情况。结果    腹腔镜组手术时间长于开放组，术中失血量少于开放组［（19±6）ml比（20±10）ml］，术后下床活动、肠胃功能恢复时间及住院时间短于开放组［（25±12）h比（50±18）h、（1.5±0.5）d比（2.1±0.5）d、（3.8±0.6）d比（6.1±1.2）d］，住院费用高于开放组，差异均有统计学意义（均P＜0.05）。腹腔镜组并发症发生率明显低于开放组［16.0%（8/50）比24.0%（12/50）］，差异有统计学意义（P＜0.05）。腹腔镜组术后24 h和1周疼痛评分均明显低于开放组，差异均有统计学意义（均P＜0.001）。2组术后6个月内均未发生复发情况。结论    腹腔镜下经腹腹膜前疝无张力修补术治疗腹股沟疝效果比传统术式更好，安全性更高。

• 【Abstract】Objective    To observe the short-term outcomes of laparoscopic transperitoneal tension-free hernioplasty and traditional hernioplasty in the treatment of inguinal hernia. Methods    A total of 100 patients with inguinal hernia admitted to Qionghai People′s Hospital, Qionghai People′s Hospital from January 2015 to January 2016 were assigned to have laparoscopic tension-free hernia repair(laparoscopic group, 50 cases) and open tension-free hernia repair(open group, 50 cases). Operation time, intraoperative blood loss, ambulation time, gastrointestinal function recovery time, postoperative hospitalization time, hospitalization expense, pain scores 24 h and 1 week after operation, complications and recurrence were analyzed. Results    Operation time in the laparoscopic group was longer, intraoperative blood loss was less［（19±6）ml vs （20±10）ml］, ambulation time, gastrointestinal function recovery time and postoperative hospitalization time were shorter［（25±12）h vs （50±18）h,（1.5±0.5）d vs （2.1±0.5）d,（3.8±0.6）d vs （6.1±1.2）d］, and hospitalization expense was higher than those in the open group（all P＜0.05）. Incidence of complications in the laparoscopic group was lower than that in the open group［16.0%（8/50） vs 24.0%（12/50）］(P＜0.05). Pain scores 24 hours and 1 week after operation in the laparoscopic group were lower than those in the open group(both P＜0.001). No recurrence occurred in 6 months after operation. Conclusion    Laparoscopic transperitoneal tension-free hernioplasty is more effective and safe than traditional operation in treating inguinal hernia.