腹腔镜完全腹膜外疝修补术和开放无张力疝修补术治疗腹股沟疝的临床应用

Clinical application of laparoscopic total extraperitoneal hernia repair and open tension-free hernia repair in the treatment of inguinal hernia

目的探讨腹腔镜完全腹膜外疝修补术(TEP)和开放无张力疝修补术治疗腹股沟疝的临床应用。方法选取2018年2月至2019年2月北大医疗鲁中医院收治的70例腹股沟疝患者作为研究对象,根据手术方式不同分为2组,每组患者35例。A组采用TEP术式,B组采用开放无张力疝修补术。对比2组患者的手术时间、术中出血量、术前术后疼痛视觉模拟评分(VAS)、术前及术后3 d应激反应指标、术后并发症情况以及总治疗费用。结果A组患者手术时间和术中出血量均显著低于B组患者(P<0.05);A组患者术后VAS评分显著低于B组患者(P<0.05);A组患者术后3 d应激反应指标显著低于B组患者(P<0.05);A组患者术后并发症发生率显著低于B组患者(P<0.05);A组患者总治疗费用显著高于B组患者(P<0.05)。结论TEP术式的临床疗效及安全性明显优于传统开腹手术,但总治疗费用较为昂贵。临床医师可根据患者自身耐受程度,以及患者的经济水平进行合理的选择。

Objective To explore the clinical application of laparoscopic total extraperitoneal hernia repair(TEP)and open tension-free hernia repair in the treatment of inguinal hernia.Methods 70 patients with inguinal hernia treated in Luzhong Hospital,Peking University Medical College from February 2018 to February 2019 were selected as the research subjects.They were divided into two groups according to different surgical methods,with 35 patients in each group.Group A was treated with TEP and group B was treated with open tension-free hernia repair.The operation time,intraoperative bleeding,preoperative and postoperative pain visual analogue scale(VAS),preoperative and 3 days postoperative stress response indexes,postoperative complications and total treatment cost were compared between the two groups.Results The operation time and intraoperative bleeding in group A were significantly lower than those in group B(P<0.05);The postoperative VAS score of group A was significantly lower than that of group B(P<0.05);The indexes of stress response 3 days postoperative in group A were significantly lower than those in group B(P<0.05);The incidence of postoperative complications in group A was significantly lower than that in group B(P<0.05);The total treatment cost of group A was significantly higher than that of group B(P<0.05).Conclusion The clinical efficacy and safety of TEP is significantly better than that of traditional laparotomy,but the total treatment cost is more expensive.Clinicians can make reasonable choices according to the patient's own tolerance and the patient's economic level.