腹腔镜经腹腹膜前修补术治疗腹股沟疝的临床价值研究

Clinical value of transabdominal preperitoneal hernioplasty for inguinal hernia

目的探讨经腹腹膜前腹腔镜疝修补术(TAPP)与开放性手术治疗腹股沟的临床效果。方法选取2016年6月至2018年6月收治的70例腹股沟疝患者,根据随机数字表发分为TAPP组和开放组各35例。采用SPSS21.0统计学软件处理数据。围手术指标、VAS评分计量资料以■表示,采用独立t检验;并发症发生率采用χ~2检验。P<0.05表示差异有统计学意义。结果 TAPP组患者手术时间、术中出血量及术后下床时间均少于开放组(P均<0.05);TAPP组患者术后24 h、 7 d、 30 d的VAS评分低于开放组(P均<0.05);TAPP组患者并发症发生率低于开放组患者(14.3%比31.4%,χ~2=6.584,P=0.010)。结论 TAPP与开放性无张力疝修补术均安全有效的,但TAPP术后患者疼痛减轻、手术时间短、创伤小及下床时间早优势。

Objective To compare the clinical effect of transabdominal preperitoneal laparoscopic hernia repair(TAPP) and open surgery for inguinal hernia. Methods From June 2016 to June 2018, 70 patients with inguinal hernia were selected and divided into TAPP group and open group according to the random number table. There were 35 cases in each group. SPSS21.0 statistics software was used to analyze. Measurement data were presented as mean ■ standard deviation and compared with the Student t test. Counting data were presented as frequencies and compared with the χ~2 test. Perioperative indicators, postoperative pain at different time points and incidence of complications during follow-up period were compared between the 2 groups. Results In TAPP group, the operation time, the amount of bleeding and the time after the operation were lower than those in the open group(P<0.05).The VAS scores of 24 h, 7 d and 30 d after operation in TAPP group were lower than those in the open group(P<0.05). The incidence of complications in TAPP group was lower than that in open group(14.3% vs. 31.4%, c^2=6.584, P=0.010). Conclusion TAPP and open tension-free herniorrhaphy are both safe and effective, but postoperative pain is reduced, operation time is short, trauma is small and the time of getting out of bed is earlier of TAPP.