腹腔镜与开放手术在成人腹股沟疝中的治疗效果比较

Effect of Laparoscopic and Open Surgery in the Treatment of Adult Inguinal Hernia

目的:分析比较腹腔镜与开放手术在成人腹股沟疝中的治疗效果。方法:选取龙岩市中医院2018年1月至2021年1月收治的103例成人腹股沟疝患者,依据患者手术治疗方案分为两组,接受腹腔镜手术治疗63例为观察组,另40例接受开放手术治疗为对照组。比较两组患者的围术期相关指标,统计治疗前、治疗后(术后24 h)的应激指标及炎症指标,评价术后并发症及随访10个月的复发率。结果:观察组患者的手术时间、术后排气、术后首次下床、住院时间、手术切口长度均短于对照组,术中出血量少于对照组,差异具有统计学意义(P<0.05);治疗后,两组患者应激指标及炎症指标水平较治疗前提升,但观察组患者应激指标及炎症指标均低于对照组,差异具有统计学意义(P<0.05);观察组患者术后并发症率低于对照组,差异具有统计学意义(P<0.05);两组患者复发率比较,差异无统计学意义(P>0.05)。结论:在成人腹股沟疝中实施腹腔镜手术,其手术时间、术后排气、术后首次下床及住院时间与手术切口长度更短,应激指标及炎症指标水平低于开放手术治疗,可有效降低并发症发生。

Objective To analyze and comparison the effect of laparoscopic and open surgery in the treatment of adult inguinal hernia.Methods A total of 103 adult patients with inguinal hernia admitted to Longyan Hospital of Traditional Chinese Medicine from January 2018 to January 2021 were selected.According to the surgical treatment plan,they were divided into two groups.63 cases underwent laparoscopic surgery as the observation group,and 40 cases underwent open surgery as the control group.The perioperative related indexes of the two groups were compared,and the stress indexes and inflammatory indexes before and after treatment(24 hours after surgery)were counted.The postoperative complications and the recurrence rate of 10 months of follow-up were evaluated.Results The operation time,postoperative exhaust,postoperative first ambulation,hospitalization time,length of surgical incision in the observation group were shorter than those in the control group,and the intraoperative blood loss was less than that in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of stress indexes and inflammatory indexes in the two groups were higher than those before treatment,but the stress indexes and inflammatory indexes in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The postoperative complication rate of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the recurrence rate between the two groups(P>0.05).Conclusion Laparoscopic surgery in the treatment of adult inguinal hernia,the operation time,postoperative exhaust,the first time to get out of bed after surgery,hospital stay and length of surgical incision are shorter,the stress index and inflammatory index levels are lower than open surgery,which can effectively reduce the incidence of complications.