腹腔镜腹股沟疝TAPP修补术治疗腹股沟疝患者效果观察

Clinical observation of laparoscopic TAPP repair for inguinal hernia in 116 cases

目的探讨腹腔镜腹股沟疝经腹腔镜腹膜前疝修补术(TAPP)治疗腹股沟疝患者116例临床效果观察。方法选取卢氏县中医院2019年1月至2021年1月收治的116例腹股沟疝患者,根据随机数字表法分为研究组和常规组,每组各58例患者。研究组行腹腔镜腹股沟疝TAPP修补术治疗,常规组给予无张力疝修补术治疗,比较两组患者手术时间和术中出血量、住院时间,采用Prince-Henry疼痛评分评价患者术后6、12、24 h疼痛程度评分及随访1个月期间的并发症发生情况。结果两组患者手术时间比较差异无统计学意义(P>0.05),两组住院时间和术中出血量比较,差异有统计学意义(P<0.05),研究组住院时间和术中出血量均低于常规组,差异有统计学意义(P<0.05)。两组术后Prince-Henry疼痛评分均呈降低趋势,研究组Prince-Henry疼痛评分小于常规组,组间、各时段、组间及时段交互作用比较,差异有统计学意义(P<0.05)。随访1个月,研究组术后有1例尿潴留,2例阴囊血肿和2例切口疼痛,常规组有尿潴留、阴囊血肿和切口疼痛各5例,两组并发症发生率比较,研究组低于常规组,差异有统计学意义(P<0.05)。结论与无张力疝修补术治疗相比,腹腔镜腹股沟疝TAPP修补术治疗腹股沟疝可减少住院时间和术中出血量,缓解患者的疼痛感,可以降低术后并发症发生率,值得应用。

Objective To investigate the clinical effect of laparoscopic anterior peritoneal hernia repair(TAPP)in the treatment of 116 patients with inguinal hernia.Methods A total of 116 patients with inguinal hernia admitted to Lushi County Hospital of Traditional Chinese Medicine from January 2019 to January 2021 were selected and divided into study group and routine group according to random number table method,with 58 patients in each group.The study group was treated with laparoscopic TAPP repair for inguinal hernia,while the conventional group was treated with tension-free hernia repair.The operative time,intraoperative blood loss and hospital stay of patients in the two groups were compared.The Pain score of patients at 6,12 and 24 h after surgery and the incidence of complications during 1 month follow-up were evaluated by Prince Henry pain score.Results There was no statistically significant difference in the operative time between the two groups(P>0.05),and there was statistically significant difference in the length of hospital stay and intraoperative blood loss between the two groups(P<0.05).The length of hospital stay and intraoperative blood loss in the research group were lower than those in the conventional group,and the difference was statistically significant(P<0.05).Prince-henry pain score decreased in both groups.Prince-henry pain score in the study group was lower than that in the conventional group,and there were statistically significant differences between groups,between time points,and between groups(P<0.05).During the 1-month follow-up,there were 1 case of urinary retention,2 cases of scrotal hematoma and 2 cases of incision pain in the study group,and 5 cases of urinary retention,scrotal hematoma and incision pain in the conventional group.The incidence of complications in the study group was lower than that in the conventional group,with statistical significance(P<0.05).Conclusion Compared with tension-free hernia repair,laparoscopic TAPP repair for inguinal hernia can reduce the length of hospital stay and intraoperative blood loss,relieve patients'sense of pain,and reduce the incidence of postoperative complications,which is worthy of application.