耻骨肌孔的空间分离解剖运用于TEP疝修补术中的疗效及安全性探析

Analysis of the efficacy and safety of spatial dissection of myopectineal orifice in total extraperitoneal hernia repair

目的探讨耻骨肌孔的空间分离解剖运用于腹腔镜完全腹膜外疝修补术(TEP)中的疗效和安全性。方法选择2013年9月至2016年9月,江阴市第五人民医院收治的TEP疝修补术患者84例,所有患者按照入院编号分为2组,单号42例纳入对照组,行TEP疝修补术;双号42例纳入观察组,行TEP疝修补术联合耻骨肌孔的空间分离解剖。观察并记录2组治疗优良率、临床指标、术后并发症发生率情况,并分析观察组四个空间解剖标志。结果观察组治疗优良率为95.24%,相比于对照组的73.81%较高;观察组并发症发生率为7.14%,相比于对照组的30.95%较低,差异有统计学意义(P<0.05);观察组手术时间及各恢复指标均优于对照组,差异有统计学意义(P<0.05)。结论耻骨肌孔的空间分离解剖运用于TEP疝修补术中可显著提高患者临床疗效,改善临床指标,减少术后并发症发生率,安全可靠,值得临床推广。

Objective To study the efficacy and safety of spatial dissection of myopectineal orifice for laparoscopic total extraperitoneal hernia repair（ TEP）. Methods 84 patients who underwent TEP repair in the Fifth People＇ s hospital from September 2013 to September 2016 were enrolled. All patients were divided into two groups according to the admission number. 42 cases with odd numbers were treated with ordinary TEP repair,and 42 cases with even number were included in the observation group to receive combined TEP repair and spatial dissection of myopectineal orifice. The excellent treatment rate,clinical indicators,postoperative complications rate were observed, and four spatial anatomical landmarks of observation group were recorded. Results The excellent treatment rate was 95. 24% in observation group and was higher than that in the control group（ 73. 81%）; the complication rate was 7. 14% in the observation group,and 30. 95% in the control group,the difference was statistically significant（P〈0. 05）;the operation time and the recovery indicators of the observation group were better than those of the control group,the difference was statistically significant（P〈0. 05）. Conclusion The spatial dissection of myopectineal orifice can improve the clinical curative effect,improve the clinical indicators and reduce the incidence of postoperative complications. It is safe and reliable,worthy of promotion in the clinical practice.