腹腔镜经腹腹膜前疝修补术和开放式无张力疝修补术治疗腹股沟疝的效果对比

Comparison of Laparoscopic Transabdominal Preperitoneal Hernia Repair and Open Tension-free Hernia Repair in the Treatment of Inguinal Hernia

目的:对比腹腔镜经腹腹膜前疝修补术和开放式无张力疝修补术治疗腹股沟疝的效果。方法:选取2022年6月—2023年12月吴江区第四人民医院收治的腹股沟疝患者62例作为研究对象,随机分为观察组(n=31,腹腔镜经腹腹膜前疝修补术)与对照组(n=31,开放式无张力疝修补术)。比较两组围术期指标、临床疗效、应激指标及并发症发生率。结果:观察组手术时间、首次下床活动时间、住院时间均短于对照组,围术期出血量少于对照组,差异有统计学意义(P<0.05);观察组总有效率高于对照组,差异有统计学意义(P=0.002);术后,两组皮质醇(CORT)、醛固酮(ALD)、去甲肾上腺素(NE)水平高于术前,观察组CORT、ALD、NE水平低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率低于对照组,差异有统计学意义(P=0.037)。结论:腹腔镜经腹腹膜前疝修补术治疗腹股沟疝的效果优于开放疝修补术,可缩短手术时间,减少出血量,促进术后恢复,有助于改善患者应激反应指标,提高临床疗效,安全性较高。

Objective:To compare the effects of laparoscopic transabdominal preperitoneal hernia repair and open tension-free hernia repair in the treatment of inguinal hernia.Methods:Sixty-two patients with inguinal hernia admitted to Wujiang District Fourth People's Hospital from June 2022 to December 2023 were selected as the study subjects,and randomly divided into the observation group(n=31,laparoscopic transabdominal preperitoneal hernia repair)and the control group(n=31,open tension-free hernia repair).Perioperative indicators,clinical efficacy,stress indicators and complication rates were compared between the two groups.Results:The operation time,first time out of bed and hospitalization time of the observation group were shorter than that of the control group,and the perioperative bleeding was less than that of the control group,the difference was statistically significant(P<0.05);the total effective rate of the observation group was higher than that of the control group,the difference was statistically significant(P=0.002);after operation,the levels of cortisol(CORT),aldosterone(ALD)and norepinephrine(NE)were higher than the preoperative levels in both groups,and the levels of CORT,ALD and NE were lower in the observation group than in the control group,the difference was statistically significant(P<0.05);the complication rate of the observation group was lower than that of the control group,the difference was statistically significant(P=0.037).Conclusion:Laparoscopic transabdominal preperitoneal hernia repair for inguinal hernia is better than open hernia repair,which can shorten the operation time,reduce the amount of bleeding,promote the postoperative recovery,help to improve the patient's stress response indexes,and improve the clinical efficacy,with a high degree of safety.