TAPP术及无张力修补术治疗双侧腹股沟疝的临床分析

Clinical Analysis of TAPP and Tension-free Hernia Repair in the Treatment of Bilateral Inguinal Hernia

目的:探讨TAPP术及无张力修补术治疗双侧腹股沟疝的临床效果。方法:对比本院收治的69例行TAPP术及开放无张力疝修补术患者的临床资料;观察手术时间、术中出血情况、术后首次下地活动时间、术后24、48、72h、1周伤口疼痛评分,术后并发症发生情况、住院天数、住院费用以及随访复发情况。结果:TAPP组在手术时间上略长于开放组,同时住院总体经济费用高于开放组;但术中出血、术后下地活动以及住院时间上明显优于开放组,差异有统计学意义(P<0.05);TAPP组术后伤口血肿、阴囊血肿、感染、局部感觉障碍及神经痛等发生率均低于开放式无张力修补术,两组间比较差异具有统计学意义(P<0.05);在术后24h、48h、72h、1周疼痛评分比较中,TAPP组患者术后各时段评分明显低于开放组患者,两组间差异具有统计学意义(P<0.05)。结论:TAPP术在双侧腹股沟疝的手术治疗上较开放式无张力修补术具有独到优势。

Objective：To discuss the clinical effect between transabdominal preperitoneal prosthetic（TAPP）and tension-free hernia repair in the treatment of bilateral inguinal hernia.Methods：Clinical information of 69 patients with TAPP and tension-free hernia repair in our hospital were compared and analyzed,including operation time,intraoperative bleeding,out-of-bed activity time,VAS score（24hours,48 hours,72hours,1week）after opeartion,postoperative complications,hospitalization days and economic cost in hospital and follow-up recurrence.Results：The operation time of TAPP group were slightly longer than that of tension-free hernia repair group,while the overall economic cost in hospital were higher than that in the tension-free hernia repair group,but there was a statistically significant difference in the operation of bleeding,postoperative lower activity and the length of stay in hospital between the two groups（P〈0.05）.The incidences of postoperative wound hematoma,hematoma of scrotum,infection,local sensory disturbance and nerve pain in the TAPP group was lower than that of tension-free hernia repair,and the differences were significant（P〈0.05）.After surgery,the TAPP group＇s VAS score（24hours,48 hours,72hours,1week）was lower than tension-free hernia repair groups,and the differences were significant（P〈0.05）.Conclusion：TAPP is superior to the tension-free hernia repair in the treatment of bilateral inguinal hernia.