开放式无张力修补术和腹腔镜完全腹膜外补片植入术治疗老年腹股沟疝的优劣差异

Open Tension-Free Repair and Laparoscopic Inguinal Hernia Repair in the Treatment Efficacy in Elderly Inguinal Hernia

目的:对比开放式无张力修补术及腹腔镜完全腹膜外补片植入术(TEP)治疗老年腹股沟疝的临床疗效差异。方法:选取2010年5月-2013年5月本院收治的66例老年腹股沟疝患者,随机数字表法分为观察组和对照组,其中观察组33例采用腹腔镜完全腹膜外补片植入术(TEP),对照组33例采用开放式无张力疝修补术,术中记录两组患者手术时间、术中出血量,术后记录两组疼痛持续时间、住院时间、住院费用、并发症的发生情况以及腹股沟疝的复发率,所有试验数据均录入统计学软件进行分析。结果:术中记录两组手术时间分别为(75.43±2.52)min、(58.25±9.31)min,术中出血分别为(1.51±0.98)m L、(10.53±9.92)m L,观察组手术时间较对照组略长,而术中出血量低于对照组,两指标比较差异均有统计学意义(P<0.05)。观察组术后疼痛时间为(0.95±0.48)d、住院时间为(4.52±1.16)d,对照组术后疼痛时间为(1.86±0.75)d,住院时间为(7.96±1.58)d,观察组疼痛时间及住院时间均低于对照组,差异均有统计学意义(P<0.05);观察组住院费为(7898.5±95.3)元,对照组住院费用为(5383.4±68.1)元,观察组略高于对照组,差异有统计学意义(t=123.3502,P=0.0000)。观察组术后并发症发生率为3.03%,对照组并发症发生率为9.09%,两组比较差异有统计学意义(P<0.05);观察组术后无复发,对照组有1例(3.03%)复发再次行手术治疗,两组复发率比较差异无统计学意义(P>0.05)。结论:腹腔镜完全腹膜外补片植入术(TEP)具有术中出血量少、住院时间短、疼痛轻微的优点,明显优于开放式无张力疝修补术,值得在临床上予以推广。

Objective：To compare the clinical curative effect of open tension-free hernia repair and laparoscopic totally extraperitoneal （TEP） in treatment of elderly inguinal hernia.Method：66 elderly patients with inguinal hernia from May 2010 to May 2013 year in our hospital were selected,they were randomly divided into observation group and control group,33 cases of observation group were treated with laparoscopic hernia repair,33 cases of the control group use open tension-free hernia repair,amount of bleeding during the operation time,two groups of patients recorded intraoperative,postoperative pain duration record of two groups,time,cost of hospitalization,complications and inguinal hernia recurrence rate in hospital,all the test data were input statistical software for analysis.Result：The intraoperative bleeding volume in observation group was significantly lower than that of the control group,compared with significant difference （P〈0.05）,but the observation group compared with the control group,operation time was slightly longer,there are differences statistically significant （P〈0.05）; postoperative pain,hospitalization time of observation group were lower than the control group,there were differences statistical significance （P〈0.05）,the observation group hospitalization cost was higher than the control group,compared the difference was statistically significant （t=123.3502,P=0.0000）; the two groups the incidence of complications compared with statistical difference （P〈0.05）, compared with no much difference recurrence rate.Conclusion：Laparoscopic totally extraperitoneal （TEP） has less bleeding, hospitalization time is short,the advantages of minor aches and pains,significantly better than open tension-free hernia repair, it is worth to be popularized in clinic.