腹腔镜经腹腔腹膜前补片腹股沟疝修补术治疗腹股沟疝的效果

Effect of transabdominal preperitoneal prosthesis in the treatment of inguinal hernia by laparoscopy

目的探讨腹腔镜经腹腔腹膜前补片腹股沟疝修补术(TAPP)治疗腹股沟疝的临床效果。方法选取2019年6月至2022年5月淮安市中医院收治的60例腹股沟疝患者作为研究对象,随机分为常规组与研究组,各30例。常规组行平片式无张力疝修补术,研究组行TAPP。比较两组数字疼痛分级法(NRS)评分、临床疗效、疾病复发率及并发症发生率。结果术后1 d、3 d、1周,研究组NRS评分[(3.03±0.71)、(2.07±0.33)、(0.67±0.12)分]明显低于常规组[(3.86±0.82)、(2.77±0.49)、(0.95±0.26)分],差异有统计学意义(P<0.05)。研究组术中出血量少于常规组,手术时间长于常规组,术后下床时间、术后肛门排气时间及出院时间均短于常规组,差异有统计学意义(P<0.05)。两组复发率、并发症发生率比较差异无统计学意义。结论与平片式无张力疝修补术应用比较,TAPP的解剖更加精细,手术视野更加广泛清晰,可有效缓解患者术后疼痛程度,减少术中出血量,缩短患者术后下床时间、术后肛门排气时间及出院时间,促进患者预后。

Objective To investigate the clinical effect of transabdominal preperitoneal prosthesis(TAPP)in the treatment of inguinal hernia.Methods A total of 60 patients with inguinal hernia treated in Huai'an Hospital of Traditional Chinese Medicine from June 2019 to May 2022 were selected as the research subjects,and they were randomly divided into the conventional group and the study group,with 30 cases in each group.The conventional group underwent flat plate tension-free hernia repair,and the study group underwent TAPP.The score of numerical rating scall(NRS),clinical efficacy,recurrence rate and complication rate were compared between two groups.Results At 1 d,3 d and 1 week after operation,the NRS score in the study group([3.03±0.71],[2.07±0.33],[0.67±0.12]scores)were significantly lower than those of the conventional group([3.86±0.82],[2.77±0.49],[0.95±0.26]scores),the differences were statistically significant(P<0.05).The amount of intraoperative blood loss in the study group was less than that in the conventional group,the operation time was longer than that in the conventional group,and the time of getting out of bed,post-operative anal exhaust time and discharge time were shorter than those in the conventional group,the differences were statistically significant(P<0.05).There were no significant differences in recurrence rate and complication rate between the two groups.Conclusion Compared with plain tab-let tension-free hernia repair,TAPP can effectively relieve postoperative pain,reduce intraoperative blood loss,shorten postoperative time to get out of bed,postoperative anal exhalation time and discharge time,and improve patient prognosis.