临床普外科电子杂志 ›› 2022, Vol. 10 ›› Issue (4): 83-.

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腹腔镜经腹腹膜前疝修补术与开放式无张力疝修补术治疗成人腹股沟疝的临床对比

  

  1. 桂平市人民医院 普通外科一区,广西 桂平 537200
  • 出版日期:2022-10-01 发布日期:2023-01-16

Clinical comparison of laparoscopic transperitoneal preperitoneal prosthesis and open tension-free hernioplasty for adult inguinal hernia

  1. Division 1 General Surgery Department of Guiping People's Hospital, Guangxi, Guiping 537200, China
  • Online:2022-10-01 Published:2023-01-16

摘要:

目的 观察成人腹股沟疝患者应用腹腔镜经腹腹膜前疝修补术(transabdominal preperitoneal prosthesis,TAPP)与开放式无张力疝修补术(open tension-free hernioptasty,OTFH)的疗效差异。方法 选取2019 年1 月至2021 年12 月桂平市人民医院收治的80 例成人腹股沟疝患者,依据随机数字表法分为观察组(TAPP 治疗)与对照组(OTFH 治疗)各40 例。记录患者手术指标,对比应激指标水平变化情况,评估临床疗效、随访并发症情况。结果 观察组患者的手术用时、下床活动时间均短于对照组,术中出血量少于对照组,差异均有显著性(P < 0.05),但两组患者的住院时间无显著差异(P > 0.05)。术后,两组各项应激指标水平均有所升高,对照组升高明显;观察组患者术后的应激指标水平均优于对照组,差异有显著性(P < 0.05)。两组患者的总有效率无显著差异(97.50% 比92.50%,P=0.608),观察组并发症总发生率小于对照组(20.00%),差异有显著性(P < 0.05)。结论 行TAPP 治疗成人腹沟疝患者,较OTFH创伤小、恢复快,可减轻机体应激反应,疗效确切,安全性高。

关键词: 经腹腹膜前疝修补术, 开放式无张力疝修补术, 成人腹股沟疝, 并发症, 应激指标

Abstract:

Objective To observe the difference between laparoscopic transperitoneal preperitoneal prosthesis (TAPP) and open tension free hernioplasty (OTFH) in the treatment of adult inguinal hernia. Method 80 adult patients with inguinal hernia admitted to Guiping People's Hospital from January 2019 to December 2021 were selected and divided into the observation group (TAPP treatment) and the control group (OTFH treatment) according to the random number table. Record the surgical indicators of patients, compare the changes of stress indicators, evaluate the clinical efficacy and follow up the complications. Result The operation time and activity time of the patients in the observation group were shorter than those in the control group, and the amount of

intraoperative bleeding was less than that in the control group, with significant differences (P < 0.05), but there was no significant difference in the hospital stay between the two groups (P > 0.05). After operation, the levels of stress indicators in both groups were increased, while those in the control group were significantly higher; The levels of stress indexes in the observation group were significantly higher than those in the control group (P<0.05). There was no significant difference in the total effective rate between the two groups (97.50% vs 92.50%, P=0.608). The total incidence of complications in the observation group was lower than that in the control group (20.00%), with a significant difference (P < 0.05). Conclusion TAPP is more effective and safe than OTFH in treating adult inguinal hernia.

Key words: Transabdominal preperitoneal prosthesis, Open tension-free hernioplasty, Adult inguinal hernia, Complication, Stress indicators