腔镜下腹直肌后修补术治疗中线腹壁疝患者的效果及对VAS评分的影响

Effect of Endoscopic Posterior Rectus Abdominis Repair in the Treatment of Midline Abdominal Wall Hernia and Its Influence on VAS Score

目的:探讨腔镜下腹直肌后修补术治疗中线腹壁疝患者的效果及对视觉模拟评分法(VAS)评分的影响。方法:选取2018年8月-2019年8月本院收治的中线腹壁疝患者62例。根据手术方法的不同分为对照组和研究组,每组31例。对照组行传统开腹手术,研究组行腔镜下腹直肌后修补术。比较两组术后不同时间段的疼痛感、胃肠功能恢复情况、并发症发生情况、手术相关指标及住院时间。结果:术后1、2、3、15 d,研究组的VAS评分均低于对照组,差异均有统计学意义(P<0.05)。研究组术后首次进食时间、肠功能恢复时间、肠鸣音恢复时间、下床活动时间、肛门排气时间均短于对照组,差异均有统计学意义(P<0.05)。研究组并发症发生率为6.5%,低于对照组的29.0%,差异有统计学意义(P<0.05)。研究组手术时间、住院时间均短于对照组,术中出血量少于对照组,差异均有统计学意义(P<0.05)。结论:腔镜下腹直肌后修补术治疗中线腹壁疝患者,可减少术后并发症发生,促进胃肠功能恢复,降低术后疼痛感,且无特殊器械的使用要求,创伤少,安全可行,是一种很好的技术补充。

Objective:To investigate the effect of laparoscopic posterior rectus repair on midline abdominal hernia and its influence on visual analogue scale (VAS) score.Method:Sixty-two patients with midline abdominal wall hernia admitted to our hospital from August 2018 to August 2019 were selected.According to different surgical methods,the patients were divided into the control group and the study group,31 cases in each group.The control group underwent conventional open surgery,the study group underwent endoscopic posterior rectus abdominis repair.The postoperative pain at different time periods,gastrointestinal function recovery,complications,operation related indicators and hospital stay were compared between two groups.Result:At 1,2,3,15 d after operation,the VAS scores of the study group were lower than those of the control group,the differences were statistically significant (P<0.05).The first feeding time,intestinal function recovery time,bowel sounds recovery time,ambulation time and anal exhaust time of the study group were shorter than those of the control group,the differences were statistically significant (P<0.05).The incidence of complications in the study group was 6.5%,it was lower than 29.0% in the control group,the difference was statistically significant (P<0.05).The operation time and hospitalization time of the study group were shorter than those of the control group,and the intraoperative blood loss was less than that of the control group,the differences were statistically significant (P<0.05).Conclusion:Endoscopic posterior rectus abdominis repair in the treatment of midline abdominal wall hernia patients,can reduce postoperative complications,promote the recovery of gastrointestinal function,reduce postoperative pain,and no special equipment requirements,less trauma,safe and feasible,is a good technical supplement.