腹腔镜与开放式无张力疝修补术治疗成人腹股沟斜疝的对比

Comparison of Laparoscopic and Open Tension-free Hernia Repair in the Treatment of Adult Indirect Inguinal Hernia

目的对比分析开放式无张力疝修补术与腹腔镜疝修补术用于临床治疗成人腹股沟斜疝的疗效及应用价值。方法选择2018年7月—2021年7月于该院接受手术治疗的腹股沟斜疝患者80例,以随机数表法划分为观察组(40例)与对照组(40例),对照组采取开放式无张力疝修补术治疗,观察组实施腹腔镜疝修补术治疗,对比治疗效果,记录各组患者临床手术指标,评估分析两组患者术后1、3 d疼痛程度变化,统计患者术后并发症总发生概率。结果两组患者临床治疗总有效率对比,差异无统计学意义(P>0.05),观察组患者手术时长及患者术后下床时间、住院总时间均明显短于对照组,术中出血量少于对照组,但住院总费用高于对照组,差异有统计学意义(P<0.05)。观察组患者术后1、3 d疼痛评分均低于对照组,使用止痛药物频率少于对照组,差异有统计学意义(P<0.05)。观察组患者术后并发症总发生率为5.00%低于对照组,差异有统计学意义(χ^(2)=14.050,P<0.05)。结论成人腹股沟斜疝患者通过采取腹腔镜无张力疝修补术治疗具有确切疗效,术后患者疼痛感低、恢复快,并发症少,提倡临床应用推广。

Objective To compare and analyze the efficacy and application value of open tension-free hernia repair and laparoscopic hernia repair in the clinical treatment of adult indirect inguinal hernia.Methods Selected 80 patients with indirect inguinal hernia who underwent surgical treatment in the hospital from July 2018 to July 2021,and divided into the observation group(40 cases)and the control group(40 cases)by the random number table method.The control group was treated with open tension-free hernia repair,and the observation group was treated with laparoscopic hernia repair.The treatment effects were compared,and the clinical operation indexes of each group of patients were recorded.To evaluate and analyze the changes in the pain degree of the two groups of patients on the 1st and 3rd day after the operation,and the total probability of postoperative complications of the patients was counted.Results There was no statistically significant difference in the total effective rate of clinical treatment between the two groups of patients(P>0.05).The length of operation,the time to get out of bed and the total length of hospital stay in the observation group were significantly shorter than those in the control group,and the amount of intraoperative blood loss was less in the control group,the total hospitalization cost was higher than that in the control group,and the difference was statistically significant(P<0.05).The pain scores of patients in the observation group were lower than those in the control group on the 1st and 3rd day after operation,and the number of times of using analgesics was less than that of the control group,the difference was statistically significant(P<0.05).The total incidence of postoperative complications in the observation group was 5.00%lower than that in the control group,the difference was statistically significant(χ^(2)=14.050,P<0.05).Conclusion Laparoscopic tension-free hernia repair in adult patients with indirect inguinal hernia has definite curative effect.The postoperative pain is low,the recovery is quick,and the complications are few.It is recommended to promote clinical application.