开放式无张力疝修补术与腹腔腹膜前疝修补术治疗腹股沟疝的有效性分析

Analysis of the Effectiveness of Open Tension-free Hernia Repair and Pre⁃peritoneal Hernia Repair in the Treatment of Inguinal Hernia

目的研究腹股沟疝患者以不同术式(开放式无张力疝修补术、腹腔腹膜前疝修补术)治疗的临床价值。方法随机选取2019年12月—2022年12月莆田涵江医院收治的148例腹股沟疝患者为研究对象,根据不同手术方法分为对照组和观察组,各74例。对照组接受开放式无张力疝修补术,观察组接受腹腔腹膜前疝修补术,对比两组患者的临床指标、并发症发生情况、炎症指标、复发情况。结果观察组手术时间(54.35±4.67)min、术后下床活动时间为(13.47±4.36)h、住院时间(3.84±0.46)d,均短于对照组的(61.59±5.31)min、(20.46±5.13)h、(4.01±0.34)d,术中出血量(19.84±5.15)mL低于对照组的(26.37±6.31)mL,差异均有统计学意义(t=8.807,8.931,2.557,6.897;P均<0.05)。观察组术后并发症总发生率低于对照组,差异有统计学意义(P<0.05)。术后1 d,两组炎症因子水平高于入院时,但观察组炎症因子水平均低于对照组,差异均有统计学意义(P均<0.05)。观察组复发率为0(0/74),低于对照组的8.11%(6/74),差异有统计学意义(χ^(2)=4.342,P=0.037)。结论腹腔腹膜前疝修补术治疗腹股沟疝在有效性方面优于开放式无张力疝修补术,手术时间短、术中出血量少、住院时间短、并发症发生率低,且炎症反应小,复发率低。

Objective To study the clinical value of different surgical methods(open tension-free hernia repair,ab-dominal preperitoneal hernia repair)in patients with inguinal hernia.Methods A total of 148 patients with inguinal hernia admitted to Putian Hanjiang Hospital from December 2019 to December 2022 were randomly selected as the re-search objects.According to different surgical methods,they were divided into control group and observation group,with 74 cases in each group.The control group received open tension-free hernia repair,and the observation group re-ceived preperitoneal hernia repair.The clinical indicators,complications,inflammatory indicators,and recurrence of the two groups were compared.Results The operation time(54.35±4.67)min,postoperative ambulation time(13.47±4.36)h and hospitalization time(3.84±0.46)d in the observation group were shorter than those in the control group(61.59±5.31)min,(20.46±5.13)h and(4.01±0.34)d,the intraoperative blood loss(19.84±5.15)mL in the observation group was lower than that in the control group(26.37±6.31)mL,the differences were statistically significant(t=8.807,8.931,2.556,6.896;all P<0.05).The total incidence of postoperative complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).At 1 day after operation,the levels of inflammatory factors in the two groups were higher than those at admission,but the levels of inflammatory in the observation group were lower than the control group,the differences were statistically significant(all P<0.05).The recurrence rate of the observation group was 0(0/74),which was lower than 8.11%(6/74)of the control group,and the difference was statistically significant(χ^(2)=4.342,P=0.037).Conclusion Abdominal preperitoneal hernia repair is su-perior to open tension-free hernia repair in the treatment of inguinal hernia in terms of effectiveness.It has short op-eration time,less intraoperative blood loss,short hospital stay,low incidence of complications,small inflammatory re-sponse and low recurrence rate.