腹腔镜经腹腔腹膜前疝修补术治疗腹股沟疝的临床效果分析

Analysis of the clinical effect of laparoscopic preperitoneal hernia repair in the treatment of inguinal hernia

目的探讨腹腔镜经腹腔腹膜前疝修补术治疗腹股沟疝的临床效果。方法选取2017年9月至2019年1月本院收治的腹股沟疝患者99例,根据不同术式分为研究组(n=50)与参照组(n=49)。研究组采用腹腔镜经腹腔腹膜前疝修补术治疗,参照组采用开放式无张力疝修补术治疗。对比两组患者的临床有效率、手术指标、术后恢复情况及并发症发生情况。结果研究组患者总有效率为91.07%,明显高于参照组的75.47%(P<0.05)。研究组患者的手术时间长于参照组,但差异无统计学意义;术中出血量少于参照组(P<0.05),且术后疼痛时间、进食时间、肛门排气时间、下床活动时间及住院时间均显著短于参照组(P<0.05)。与参照组患者的术后并发症发生率(30.61%)、复发率(10.20%)相比,研究组患者的术后并发症发生率(16.00%)、复发率(2.00%)均明显更低(P<0.05)。结论相比开放式无张力修补术,腹腔镜经腹腔腹膜前疝修补术治疗腹股沟疝的效果更加理想,能明显缩短患者术后各项指标恢复的时间以及能减少术中出血量和术后并发症,且不会增加术后复发率,值得临床应用推广。

Objective To investigate the clinical effect of laparoscopic preperitoneal hernia repair in the treatment of inguinal hernia.Methods A total of 99 patients with inguinal hernia admitted to our hospital from September 2017 to January 2019 were selected and they were divided into the study group(n=50)and the reference group(n=49)according to different operation methods.The study group was treated with laparoscopic transperitoneal preperitoneal hernia repair and the control group was treated with open tension-free hernia repair.The clinical efficiency,surgical indexes,postoperative recovery and complications of the two groups were compared.Results The total effective rate of the study group was 91.07%,which was significantly higher than that of the control group(P<0.05).The operation time of the study group was longer than that of the reference group,but the difference was not statistically significant.The intraoperative blood loss was less than that of the control group(P<0.05),and the postoperative pain time,feeding time,anal exhaust time,out-of-bed activity time and hospitalization time were significantly shorter than that of the control group(P<0.05).Compared with 30.61%and 10.20%of the patients in the control group,16.00%and 2.00%of the patients in the study group had significantly lower rates of postoperative complications and recurrence(P<0.05).Conclusion Compared with open tension-free repair,laparoscopic transperitoneal preperitoneal hernia repair is more effective in the treatment of inguinal hernia,which can significantly shorten the recovery time of postoperative indicators,reduce intraoperative blood loss and postoperative complications,and does not increase postoperative recurrence rate,which is worthy of clinical application and popularization.