经腹腔腹膜前腹腔镜腹股沟疝修补术的临床应用研究

Clinical Application Research of Transabdominal Preperitioneal Laparoscopic Inguinal Hernia Repair

目的:探讨经腹腔腹膜前腹腔镜腹股沟疝修补术(TAPP)的临床应用效果。方法:选取2017年1月-2018年12月本院收治的240例腹股沟疝患者为研究对象,利用随机数字表法将其分成研究组和对照组,每组120例。研究组患者采用TAPP治疗方案,对照组采用常规开放性无张力疝修补术。比较两组围手术期一般情况(术中出血量、手术费用、住院时间、术后恢复正常活动时间、手术时间、肛门排气时间及术后肠鸣音恢复时间)、术后各时间段VAS评分及并发症发生情况。结果:研究组术中出血量少于对照组,住院时间、术后恢复正常活动时间、肛门排气时间及术后肠鸣音恢复时间均短于对照组,而手术时间长于对照组,手术费用高于对照组,差异均有统计学意义(P<0.05)。术后24 h、7 d、30 d,研究组VAS评分均低于对照组,差异均有统计学意义(P<0.05)。研究组并发症发生率为3.33%,明显低于对照组的12.50%,差异有统计学意义(P<0.01)。结论:对于腹股沟疝患者,TAPP具有创伤小、恢复快、患者术后疼痛强度低和并发症少的优点。

Objective:To investigate the clinical effect of transabdominal preperitioneal laparoscopic inguinal hernia repair (TAPP).Method:A total of 240 cases of inguinal hernia patients admitted to our hospital from January 2017 to December 2018 were selected as research objects.Using the random number table method,they were divided into study group and control group,120 cases in each group.Patients in the study group were treated with TAPP.The control group received conventional open tension-free hernia repair.Perioperative general conditions (intraoperative blood loss,surgical expenses,length of stay,postoperative recovery time,operative time,anal exhaust time and postoperative recovery time of bowel sounds),VAS score and complications were compared between the two groups.Result:Intraoperative blood loss in the study group was less than that in the control group,the length of hospital stay,postoperative recovery time,anus exhaust time and postoperative bowel sounds recovery time were shorter than those in the control group,the surgery time was longer than that of control group,the surgery cost more than that of control group,the differences were statistically significant (P<0.05).24 hours,7 days and 30 days after the operation,VAS scores of the study group were lower than those of the control group,the differences were statistically significant (P<0.05).The complication rate of the study group was 3.33%,significantly lower than 12.50% in the control group,the difference was statistically significant (P<0.01).Conclusion:For patients with inguinal hernia,TAPP has the advantages of small trauma,rapid recovery,low postoperative pain intensity and fewer complications.