腹腔镜腹壁切口疝无张力修补术疗效及安全性观察

Clinical Efficacy and Safety of Laparoscopic Abdominal Incision Hernia Repair

目的总结分析腹腔镜腹壁切口疝无张力修补术的临床应用效果。方法采用随机数字表法将濮阳市中医院外科2012年6月—2014年6月收治的88例腹壁切口疝患者进行分组,对照组34例给予开放手术治疗,观察组54例给予腹腔镜下修补术,观察两组手术、术后排气、住院等所需时间,并观察术后疼痛、术后血肿及感染发生等指标,评价疗效及安全性。结果观察组患者手术时间(92.56±4.29)min明显长于对照组的(65.27±6.83)min,术后排气时间(1.5±0.5)d、住院时间(6.5±1.5)d、疼痛评分(1.5±0.9)分均明显低于对照组的(3.24±0.62)d、(10.58±2.82)d、(1.54±0.96)分,组间差异有统计学意义(P<0.01),观察组术后血清肿发生率16.67%及感染发生率3.70%分别低于对照组的23.93%、5.88%,但差异无统计学意义(P>0.05)。结论与传统开腹修补手术相比,腹腔镜腹壁切口疝无张力修补术也是安全有效的,而且住院时间、临床效果及术后并发症等指标更佳,值得推广使用。

Objective Clinical application of laparoscopic repair of abdominal incision hernia without tension. Methods Using the random number table method the Puyang City Hospital of traditional Chinese medicine surgery, June 2012 to June 2014 88 cases of abdominal incisional hernia patients were divided into three groups, 34 cases in the control group were treated with open surgery in the treatment, observation group（54 cases） were treated with laparoscopic repair, to observe the two groups of operation, postoperative exhaust, hospitalization required time and observe the postoperative pain, postoperative hematoma and infection occurred and other indicators and to evaluate the efficacy and safety. Results Observation group, operation time（92.56 ±4.29） min was significantly longer than that of the control group（65.27±6.83） min,（1.5 ±0.5） d postoperative exhaust time, hospitalization time（6.5 ±1.5） d, pain score（1.5±0.9）scores were significantly lower than control group（3.24±0.62）d,（10.58±2.82）d,（1.54 ＋ 0.96） scores, significant difference between the two groups（P 〈0.01）, observation group postoperative seroma occurred rate was 16.67% and the infection rate of 3.70% were lower than those of the control group 23.93%, 5.88%, but the difference was not significant（P 〉0.05）. Conclusion Compared with traditional open surgery, laparoscopic abdominal wall incision hernia repair is safe and effective, and the hospital stay, clinical effect and postoperative complications, and other indicators are better,it is worth promoting.