腹腔镜经腹腹膜前修补术术中对Ⅲ型腹股沟斜疝疝囊采用完全剥离与横断处理的临床观察

Efficacy observation of total removal and cross-sectional processing for typeⅢof oblique inguinal hernia sac during laparoscopic transabdominal preperitoneal repair

目的研究腹腔镜经腹腹膜前修补术术中完全剥离与横断处理两种方法应用于Ⅲ型腹股沟斜疝疝囊中的价值。方法选择该院2017年3月至2019年2月纳入的90例Ⅲ型腹股沟斜疝患者作为研究对象,遵照随机数字表法分为A、B两组,每组各45例,A组采取横断处理,B组采取完全剥离,比较两组患者治疗结果。结果A组患者手术时长、出血量、腹股沟区积液及住院时间均少于B组,差异均有统计学意义(P<0.05)。两组患者治疗前视觉模拟评分法(VAS)评分比较,差异均无统计学意义(P>0.05),A组患者治疗1 d、3 d及1周后VAS评分均低于B组,差异均有统计学意义(P<0.05)。A组患者并发症发生率为6.67%,明显低于B组的17.78%,差异有统计学意义(P<0.05)。两组患者治疗前生理机能、健康状况、社会功能、精神健康评分比较,差异均无统计学意义(P>0.05);A组患者治疗后各项评分均高于B组,差异均有统计学意义(P<0.05)。结论腹腔镜经腹腹膜前修补术术中对疝囊实施横断处理效果更好,可有效控制Ⅲ型腹股沟斜疝患者的病情,明显减少并发症发生率,安全性高,可快速降低疼痛,缩短治疗时间,提升生活质量,为预后提供保障。

Objective To study the clinical value of total removal and cross-sectional processing for typeⅢof oblique inguinal hernia sac during laparoscopic transabdominal preperitoneal repair.Methods A total of 90 patients with typeⅢof oblique inguinal hernia sac treated from March 2017 to February 2019 in the hospital were selected and randomly assigned to group A and group B,45 cases in each group.Group A took the total removal of hernia sac treatment,and group B took the cross-sectional processing of hernia sac treatment.The therapeutic effect was assessed in two groups.Results Compared with group B,the operation time,blood loss,effusion of inguinal region and hospitalization time in group A were dramatically reduced,and the differences were statistically significant(P<0.05).Visual analogue scale(VAS)scores between the two groups before treatment were not significantly different(P>0.05).VAS scores on 1 d,3 d and 1 week after treatment in group A were lower than those in group B,and the differences were statistically significant(P<0.05).The complication rate in group A was 6.67%,which was significantly lower than that in group B(17.78%),and the difference was statistically significant(P<0.05).The scores of physiological function,health status,social function and mental health before treatment between the two groups were not significantly different(P>0.05).Related scores in group A after treatment were higher than those in group B,and the difference was statistically significant(P<0.05).Conclusion During laparoscopic transabdominal preperitoneal repair,the cross-sectional processing of hernia sac is proven to be more effective,which can control patient′s illness state,reduce the complication rate,increase the clinical safety,relieve the pain,shorten the treatment time,and improve the life quality and treatment prognosis.