腹腔镜下与开放式无张力疝修补术手术相关指标及并发症比较

Comparison of operative parameters and complications between laparoscopic tension-free herniorrhaphy and open tension-free hernia repair

目的比较腹腔镜下与开放式无张力疝修补术手术的相关指标及并发症。方法选择2015年1月至2018年4月于庐江县人民医院腹股沟疝患者80例,随机分为观察组(40例)和对照组(40例)。对照组行开放式无张力疝修补术,观察组行腹腔镜下无张力疝修补术。比较2组患者的临床指标及并发症。结果观察组术后疼痛持续、住院、恢复家庭活动时间均短于对照组,手术时间长于对照组(P<0.05);术后24 h,2组患者的C反应蛋白(CRP)、白细胞介素6(IL-6)水平均升高,且观察组的IL-6、CRP水平低于对照组(P<0.05)。观察组的住院费用高于对照组(P<0.05)。组内比较,术后1、3、6个月的腹股沟疼痛调查表(IPQ)评分均低于术前(P<0.05);组间比较,术后1、3个月,观察组的IPQ评分低于对照组(P<0.05)。2组患者术后并发症比较,差异无统计学意义(P>0.05)。结论腹腔镜下无张力疝修补术治疗腹股沟疝,费用较高,但创伤小,机体应激反应低,术后疼痛少,利于预后,可结合患者经济情况及病情选择治疗方案。

Objective To compare the operative parameters and complications between laparoscopic tension-free herniorrhaphy and open tension-free hernia repair.Methods 80 patients with inguinal hernia were randomly divided into the observation group and the control group(n=40 in each group).The control group received open tension-free hernia repair,while the observation group underwent laparoscopic tension-free hernia repair.Clinical indicators and complications were compared between two groups.Results The operation time,postoperative pain duration time,hospitalization time and recovery time of family activity in the observation group were lower than those in the control group,the operation time was high than those in the control group(P<0.05).At 24 hours after operation,the levels of C-reactive protein(CRP),interleukin 6(IL-6)increased in both groups,and the levels of IL-6 and CRP in the observation group were lower than those in the control group(P<0.05).The hospitalization cost in the observation group was higher than that in the control group(P<0.05).The scores of inguinal pain questionnaire(IPQ)at 1,3 and 6 months after operation were lower than those before operation(P<0.05).The scores of IPQ in the observation group were lower than the control group at 1 month and 3 months after operation(P<0.05).There was no significant difference in postoperative complications between the two groups(P>0.05).Conclusion Laparoscopic tension-free herniorrhaphy for inguinal hernia is costly,but less traumatic,less stress response,and less pain,and it is beneficial to prognosis.The treatment can be selected according to the patient’s economic situation and clinical condition.