经腹腹膜前与疝环充填式疝修补术治疗腹股沟疝的对照研究

A comparative study of laparoscopic trans-abdominal preperitoneal hernia repair and mesh plug hernia repair in the treatment of inguinal hernia

目的探讨腹腔镜经腹腹膜前疝修补术(TAPP)与疝环充填式无张力疝修补术(Mesh-Plug)对腹股沟疝患者的疗效。方法回顾性选取2020年1月至2022年1月庐江县中医院收治的60例腹股沟疝患者,据手术方式分为TAPP组和Mesh-Plug组。TAPP组34例,采用腹腔镜下TAPP治疗,Mesh-Plug组26例,采用开放式Mesh-Plug术治疗。对比2组患者围手术期情况、术后疼痛、炎性因子、术后并发症情况。结果TAPP组手术时间长于Mesh-Plug组;术中出血量,术后排气时间、下床时间及住院时间均少于Mesh-Plug组(P<0.05);住院费用高于Mesh-Plug组(P<0.05)。TAPP组术后6、24、48 h疼痛数字评分量表(NRS)评分均低于Mesh-Plug组(P<0.05);TAPP组术后1 d内使用镇痛药率低于Mesh-Plug组(5.88%vs 26.92%)(P<0.05)。TAPP组术后C反应蛋白和淀粉样蛋白A低于Mesh-Plug组(P<0.05)。TAPP组术后总并发症发生率为8.57%,低于Mesh-Plug组的34.62%(P<0.05)。结论两种术式均可有效治疗腹股沟疝。TAPP的临床疗效更好,可有效减轻术后疼痛,降低术后并发症,促进患者术后恢复,缩短住院时间。

Objective To explore the curative effect of laparoscopic trans-abdominal preperitoneal(TAPP)hernia repair and mesh plug(Mesh-Plug)hernia repair on patients with inguinal hernia.Methods A total of 60 patients with inguinal hernia admitted to Lujiang Hospital of Traditional Chinese Medicine between January 2020 and January 2022 were retrospectively enrolled.According to different surgical methods,they were divided into TAPP group(n=34,received TAPP hernia repair)and Mesh-Plug group(n=26,received open Mesh-Plug hernia repair).The perioperative conditions,postoperative pain,inflammatory factors and postoperative complications in the two groups were compared.Results The operation time in TAPP group was longer than that in Mesh-Plug group,intraoperative blood loss was less than that in Mesh-Plug group,postoperative exhaust time,leaving bed time and hospitalization time were shorter than those in Mesh-Plug group(P<0.05).The hospitalization cost in TAPP group was higher than that in Mesh-Plug group(P<0.05).At 6,24 and 48 h after surgery,scores of Numerical Rating Scale(NRS)in TAPP group were lower than those in Mesh-Plug group(P<0.05).The rate of analgesics use within 1 d after surgery in TAPP group was lower than that in Mesh-Plug group(5.88%vs 26.92%,P<0.05).After surgery,levels of C-reactive protein and serum amyloid A in TAPP group were lower than those in Mesh-Plug group(P<0.05).The total incidence of postoperative complications in TAPP group was lower than that in Mesh-Plug group(8.57%vs 34.62%,P<0.05).Conclusion Both TAPP and Mesh-Plug hernia repair can effectively treat inguinal hernia.TAPP has better clinical curative effect,which can effectively relieve postoperative pain,reduce the risk of postoperative complications,promote postoperative recovery and shorten hospitalization time.