不同手术方法治疗腹股沟疝的效果观察

Effect observation of different surgical methods in treatment of inguinal hernia

目的比较开放疝修补术与改良腹腔镜全腹膜外疝修补术治疗腹股沟疝的效果。方法选取2013年6月—2015年6月收治的190例腹股沟疝患者,随机分为对照组86例和观察组104例。对照组患者予以开放性全腹膜外疝修补术,观察组患者予以改良腹腔镜全腹膜外疝修补术。比较两组患者的手术时间、住院时间、下床活动时间、视觉模拟评分(visual analogue scale,VAS)、术后并发症、复发情况等。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果观察组患者的住院时间[(5.13±1.33)d]、下床活动时间[(12.78±2.54)h]均明显短于对照组[(8.78±1.67)d、(27.79±5.31)h],差异均有统计学意义(均P<0.05),观察组VAS评分[(3.17±1.02)分]显著低于对照组[(7.31±1.32)分],差异有统计学意义(P<0.05)。观察组患者的并发症总发生率(13.56%)明显低于对照组(30.27%),差异有统计学意义(P<0.05)。结论与开放性全腹膜外疝修补术相比,改良腹腔镜全腹膜外疝修补术是治疗腹股沟疝的有效、安全的手术方式,能有效缩短患者的住院时间及下床活动时间,减轻患者的术后疼痛,降低并发症发生率。

Objective To compare effect observation of open style hernia plastic operation and total extraperitoneal prosthetic of improved laparoscopic in treatment of inguinal hernia. Methods 190 cases of inguinal hernia from June 2013 to June in 2015 were selected,all patients were randomly divided into control group（ n = 86） and observation group（ n = 104）.The control group was given open style hernia plastic operation,the observation group was treated total extraperitoneal prosthetic of improved laparoscopic. Operative time,hospital stay,ambulation time,visual analogue scale（ VAS）,complications were compared. Measurement data was processed by t test,count data was used by chi square test,P〈0. 05 was considered statistically significant. Results Hospital stay[（ 5. 13 ± 1. 33） d],ambulation time[（ 12. 78 ± 2. 54） h] of observation group was significantly shorter than the control group[（ 8. 78 ± 1. 67） d,（ 27. 79 ± 5. 31） h]（ P〈0. 05）. VAS of observation group [（ 3. 17 ± 1. 02） score]was significantly lower than the control group[（ 7. 31 ± 1. 32） score]（ P〈0. 05）. Overall incidence with complication of observation group（ 13. 56%） was significantly lower than the control group（ 30. 27%）.Conclusions Compared with open style hernia plastic operation,total extraperitoneal prosthetic of improved laparoscopic is a safe and effective surgical method of treating inguinal hernia,it can effectively shorten the hospital stay and ambulation time,reduce postoperative pain of patient,reduce the incidence of complications.