腹腔镜经腹膜前间隙无张力修补术在成人疝气治疗中的效果

The effect of laparoscopic preperitoneal tension-free hernioplasty in the treatment of adult hernia

目的观察成人疝气临床治疗中应用腹腔镜经腹膜前间隙无张力修补术的效果。方法80例成人疝气患者,以入院时间先后分为对照组及观察组,每组40例。对照组实施传统无张力疝修补术,观察组实施腹腔镜经腹膜前间隙无张力修补术。比较两组患者的临床相关指标,不同时间点的疼痛评分,术后并发症发生率及疾病复发率,生活质量评分。结果观察组的手术时间(43.12±7.56)min、术后疼痛持续时间(1.11±0.21)d、肛门首次排气时间(10.96±2.14)h、首次下床活动时间(15.24±5.61)h、住院时间(7.12±2.84)d短于对照组的(74.15±11.12)min、(2.45±0.33)d、(15.69±3.12)h、(28.62±7.45)h、(12.85±4.51)d,术中出血量(71.15±12.65)ml少于对照组的(135.52±24.52)ml,差异具有统计学意义(P<0.05)。观察组患者术后6、12、24、72 h的视觉模拟评分法(VAS)评分分别为(4.59±2.08)、(3.87±1.74)、(3.24±1.26)、(2.51±1.02)分,均低于对照组的(6.59±2.14)、(5.81±1.87)、(5.29±1.56)、(4.01±1.22)分,差异具有统计学意义(P<0.05)。观察组患者的术后并发症发生率2.50%低于对照组的20.00%,差异具有统计学意义(P<0.05)。两组患者的疾病复发率比较,差异无统计学意义(P>0.05)。两组患者术前的生活质量评分比较,差异无统计学意义(P>0.05);观察组患者出院前的生活质量评分(84.68±8.21)分高于对照组的(78.69±6.31)分,差异具有统计学意义(P<0.05)。结论对成人疝气应用腹腔镜经腹膜前间隙无张力修补术更利于缩减患者的手术时间、术后恢复时间,降低术后疼痛程度,改善预后。

Objective To observe the effect of laparoscopic preperitoneal tension-free hernioplasty in the treatment of adult hernia.Methods A total of 80 adult patients with hernia were divided into control group and observation group according to the time of admission,with 40 cases in each group.The control group underwent traditional tension-free hernioplasty,and the observation group underwent laparoscopic preperitoneal tensionfree hernioplasty.The clinical related indicators,pain scores at different time points,postoperative complications and disease recurrence rate,and quality of life scores were compared between the two groups.Results In the observation group,the operation time(43.12±7.56)min,postoperative pain duration(1.11±0.21)d,first anal exhaust time(10.96±2.14)h,first ambulation time(15.24±5.61)h,hospitalization time(7.12±2.84)d were shorter than(74.15±11.12)min,(2.45±0.33)d,(15.69±3.12)h,(28.62±7.45)h,(12.85±4.51)d in the control group;the intraoperative blood loss(71.15±12.65)ml was less than(135.52±24.52)ml in the control group;all the differences were statistically significant(P<0.05).The visual analogue scale(VAS)scores in the observation group at 6,12,24,and 72 h after surgery were(4.59±2.08),(3.87±1.74),(3.24±1.26),and(2.51±1.02)points,which were lower than(6.59±2.14),(5.81±1.87),(5.29±1.56),and(4.01±1.22)points in the control group,and the differences were statistically significant(P<0.05).The incidence of postoperative complications 2.50%in the observation group was lower than 20.00%in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the disease recurrence rate between the two groups(P>0.05).There was no statistically significant difference in the preoperative quality of life score between the two groups(P>0.05).The quality of life score of the observation group was(84.68±8.21)points before discharge,which was higher than(78.69±6.31)points of the control group,and the difference was statistically significant(P<0.05).Conclusion Laparoscopic preperitoneal tension-free hernioplasty for adult hernia is more beneficial to reduce the operation time,postoperative recovery time,reduce postoperative pain,and improve prognosis.