腹腔镜联合血浆冷沉淀与开放式无张力疝修补术治疗腹股沟复发疝的临床对比研究

The comparative study of transabdominal preperitoneal prosthetic(TAPP) combined with blood cryoprecipitate and open tension-free herniorrhaphy in treating patients with recurrent inguinal hernia

目的探讨腹腔镜经腹膜前疝修补术（TAPP）联合血浆冷沉淀治疗腹腔股沟复发疝的安全性和有效性。方法回顾性分析2011年1月至2013年11月我科收治的60例腹股复发疝患者（斜疝38例,直疝22例）的临床资料,其中TAPP联合血浆冷沉淀腹股疝修补术32例为试验组（斜疝21例,直疝11例）;开放式无张力疝修补术28例为对照组（斜疝17例,直疝11例）。术后所有患者均得到随访,随访时间12-35个月（中位时间18个月）。结果两组患者手术时间、术后住院时间比较均无统计学意义（P〉0.05）;观察组患者住院费用高于对照组,差异有统计学意义（P〈0.05）;两组患者在随访期间均无复发,试验组总并发症发生率为3.13%（1/32）,对照组为25.00%（7/28）,差异有统计学意义（P〈0.05）。结论 TAPP联合血浆冷沉淀治疗腹股沟复发疝安全有效,术后并发症少,为临床上治疗腹腔股沟复发疝提供了一种新的选择方式。

Objective To investigate the safety and effectiveness of transabdominal preperitoneal prosthetic（TAPP） combined with blood cryoprecipitate in the treatment of patients with recurrent inguinal hernia. Methods Various clinical parameters of 60 cases of patients with recurrent inguinal hernia（indirect hernia： 38; direct hernia： 22） in our section from Jan 2011 to Nov 2013 were analyzed. And 32 cases of patients（indirect hernia： 21 patients, direct hernia： 11 patients） were treated by TAPP and blood cryoprecipitate（study group）, while other 28 cases of patients（indirect hernia： 17 patients,direct hernia： 11 patients） were treated by open tension-free herniorrhaphy（control group）. All the patients were followed up for 12-35 months（median 18 months） after operation. Results The operation time and the length of stay between the two groups had no significant difference（P〉0.05）; The hospitalization expenses in study group was significantly higher than that in control group（P〈0.05）; During the follow-up period, there were no recurred in both groups, and the complication rate accounted for 3.13%（1/32） in study group while 25.00%（7/28） in control group, difference was statistically significant（P〈0.05）.Conclusion TAPP combined with blood cryoprecipitate applied in patients with recurrent inguinal hernia was safe and effective, and with fewer complications, so as to provide a new and useful way in treating patients with recurrent inguinal hernia in clinical.