腹股沟斜疝患者TAPP术后疝囊残端不同处理方式的比较分析

Comparative analysis of different treatment methods of hernia sac stump after TAPP operation in patients with indirect inguinal hernia

目的 探讨腹股沟斜疝患者TAPP术后疝囊残端不同处理方式的比较分析。方法 选取本院2018年1月-2019年12月收治的86例腹股沟斜疝患者,根据随机数字表法将其分为横断组、剥离组两组,横断组43例,剥离组43例。比较两组患者的手术相关指标和术后相关指标以及第一天VAS疼痛评分与并发症发生率。结果 对比两组患者的手术时间和术中出血量,结果发现,横断组的手术时间较剥离组短,横断组的术中出血量较剥离组少(P <0.05)。两组患者术后住院时间相差不大,无统计学意义(P> 0.05),横断组术后第一天VAS评分较剥离组低,有统计学意义(P <0.05);对比两组的并发症发生率,结果发现,横断组的并发症血清肿和神经异常的总发生率较剥离组低,有统计学意义(P <0.05)。结论 采用疝囊横断和剥离的处理方式治疗腹股沟斜疝患者均有良好的临床疗效,但横断疝囊的处理方式更能缩短手术时间,术中出血量小、疼痛度低,且并发症发生率低,临床运用效果更佳。

Objective To compare and analyzeabout different treatment methods of the stump of the hernia sac after TAPP in patients with indirect inguinal hernia. Methods 86 patients with indirect inguinal hernia treated in our hospital from January 2018 to December 2019 were randomly divided into transection group and dissection group, with 43 cases in transection group and 43 cases in dissection group. The operation related indexes, postoperative related indexes, VAS pain score on the first day and the incidence of complications were compared between the two groups. Results The operation time and intraoperative blood loss between two groups were compared, it was found that the operation time of the transection group was shorter than that of the dissection group, and the intraoperative blood loss of the transection group was less than that of the dissection group(P < 0.05). The postoperative hospital stay between the two groups was not significantly different(P > 0.05). The VAS score of the transection group at the first day after surgery was lower than that of the dissection group, and the differences were statistically significant(P < 0.05). The total incidence of complication seroma and neurological abnormalities in the transection group was lower than that in the dissection group(P < 0.05). Conclusion The treatment of indirect inguinal hernia by hernia sac transection and dissection has good clinical effects, but the treatment of transection of the hernia sac can shorten the operation time, the amount of intraoperative bleeding is low, the pain is low, the incidence of complications is low,and the clinical application effect is better.