腹腔镜下经腹腔腹膜前疝修补术后应用芒硝外敷防治血清肿的临床研究

Clinical study of mirabilite external use to prevent and treat seroma following laparoscopic transabdominal preperitoneal hernia repair

目的:探讨腹腔镜下经腹腔腹膜前腹股沟疝修补术后应用芒硝外敷防治血清肿的的临床疗效。方法:选取安徽省亳州市中医院2021年8月—2022年3月普通外科收治的腹股沟疝拟行腹腔镜疝修补术患者120例,采用随机数字表法随机分试验组和对照组,每组各60例。两组均接受腹腔镜下经腹腔腹膜前疝修补术(TAPP)。试验组术后即予以芒硝外敷,对照组予以沙袋压迫。比较两组患者术后血清肿发生情况以及其他手术指标。结果:两组患者在术后1 d VAS评分[(4.15±1.15)分vs(5.62±1.22)分],差异有统计学意义(P<0.05)。在术后1 d、3 d、7 d、30 d血清肿发生率、术后1 d、3 d、7 d阴囊肿胀发生率、住院时间[(4.72±1.42)d vs(5.22±1.38)d]、手术时间[(108.20±46.41)min vs(104.17±44.52)min]、术中出血量[(5.83±0.94)m L vs(5.80±0.90)mL]差异无统计学意义(P>0.05)。结论:TAPP术后应用芒硝外敷可减轻术后疼痛,有助于降低术后血清肿的发生率,从而促进患者的快速康复,具有简单、方便及价廉等优势,值得临床推广使用。

Objective To evaluate the clinical efficacy of mirabilite external use to prevent and treat seroma following laparoscopic trans-abdominal preperitoneal hernia repair.Methods A total of 120 patients admitted to the general surgery department at Bozhou Hospital of Traditional Chinese Medicine in Anhui Province for laparoscopic hernia repair between August 2021 and March 2022 were randomly divided into a test group and a control group,with 60 cases in each group,using table of random numbers.Both patient groups underwent laparoscopic transabdominal preperitoneal hernia repair(TAPP).Immediately after surgery,mirabilite was given in the experimental group,whereas sandbags were used in the control group.The occurrence of postoperative seroma between the two groups was compared.Results Data from the two groups showed statistically significant differences in the postoperative 1 d VAS score(4.15±1.15 vs 5.62±1.22)(P<0.05).In terms of seroma incidence at 1 d(10 vs 16),3 d(7 vs 11),7 d(2 vs 4),30 d(1 vs 3),scrotal edema incidence at 1 d(12 vs 20),3 d(2 vs 5),7 d(1 vs 3),length of stay(4.72±1.42 vs 5.22±1.38),surgery length(108.20±46.41 vs 104.17±44.52),intraoperative bleeding(5.83±0.94 vs 5.80±0.90),however,there were no statistically significant differences(P>0.05).Conclusion Utilizing mirabilite following TAPP can alleviate patients'postoperative pain,reduce the rate of postoperative seroma,and expedite patients'recovery,which offers the benefits of simplicity,convenience,and low cost and merits clinic reference.