气腹针导引加预分离技术在完全腹膜外腹股沟疝修补术中应用

Application of pneumoperitoneum needle guidance and pre-separation technique in complete extraperitoneal inguinal hernia repair

目的 探索气腹针导引并经气腹针注入麻醉肿胀液在完全腹膜外腹股沟疝修补术(totally extraperitoneal hernia repair,TEP)中的应用效果。方法 收集宿州市立医院2018年1月至2019年12月期间外科腹股沟斜疝病人60例,采用气腹针导引并经气腹针注入麻醉肿胀液注射组(试验组)与传统TEP对照组各30例,试验组在传统TEP手术基础上应用麻醉肿胀液行预分离,对照组行传统TEP手术。比较两组病人术中用时、出血量、腹膜破裂例数,术后疼痛、皮下与阴囊血清肿、排气及卧床用时。结果 试验组手术用时(74.17±12.27)min比(88.70±13.26)min、腹膜破裂例数(1比8)、术中出血量(13.57±5.12)mL比(24.30±7.62)mL、术后血清肿形成(0比5)、术后疼痛(3.77±1.41)分比(5.77±1.94)分等均低于对照组,差异有统计学意义(均P<0.05)。结论 气腹针导引并经气腹针注入麻醉肿胀液应用TEP与传统TEP比较,可明显降低手术难度、缩短手术时间、降低术中及术后并发症的发生,是一种安全有效的手术方式。

Objective through pneumoperitoneum needle in complete extraperitoneal inguinal hernia repair(totally experiperitoneal hernia repair,TEP).Methods A total of 60 patients with inguinal hernia in Department of General Surgery Suzhou Municipal Hospital from January 2018to December 2019 were selected and randomly assigned into experimental group and control group.The experimental group was guided by pneumoperitoneum needle and injected with anesthesia solution based on traditional TEP operation,while the control group was subjected to traditional TEP surgery,and 30 cases in each group.The intraoperative time,amount of bleeding,number of peritoneal ruptures,postoperative pain,subcutaneous and serom,venting,and bedtime were compared between the two groups of patients.Results Lower operating time [(74.17±12.27) min vs.(88.70±13.26) min],fewer peritoneal ruptures(1 vs.8),intraoperative blood loss [(13.57±5.12) mL vs.(24.30±7.62) mL],postoperative hematoma formation(0 vs.5),and postoperative pain [(3.77±1.41) scores vs.(5.77±1.94)scores] in the experimental group were lower than those in the control group,and the difference was statistically significant(P<0.05).Conclusions Compared with traditional TEP,Guided by pneumoperitoneum needle and injected with anesthesia solution on TEP can significantly reduce the difficulty of surgery,shorten the operation time,and reduce the occurrence of intraoperative and postoperative complications.It is a safe and effective surgical method.