腹腔镜经腹膜前疝修补术对腹股沟疝的治疗作用

Effect of transabdominal preperitioneal laparoscopic herniorrhaphy in treating inguinal hernia

  • 摘要:
      目的  探讨腹腔镜经腹膜前疝修补术对腹股沟疝的临床疗效。
      方法  选取82例腹股沟疝患者随机分为对照组与观察组,各41例,对照组实施无张力疝修补术,观察组实施腹腔镜下经腹膜前疝修补术,比较2组的手术情况、术后并发症发生率、术后恢复情况、住院费用、术后疼痛评分、血清炎症因子指标、术后复发率。
      结果  观察组的手术时间显著短于对照组,术中出血量显著少于对照组(P < 0.05); 观察组术后并发症总发生率显著低于对照组(P < 0.05); 观察组排气恢复时间、住院时间显著短于对照组,住院费用显著少于对照组(P < 0.05); 观察组术后8、12、24、48 h的疼痛评分均显著低于对照组(P < 0.05); 观察组手术后血清炎症因子指标C反应蛋白(CRP)、白细胞介素-6(IL-6)、降钙素原(PCT)水平均显著低于对照组(P < 0.05); 术后随访6个月, 2组复发率比较,差异无统计学意义(P>0.05)。
      结论  在腹腔镜下实施经腹膜前疝修补术,可有效减轻腹股沟疝患者的手术创伤,有利于加快术后恢复速度,减轻患者经济负担。

     

    Abstract:
      Objective  To investigate the clinical effect of transabdominal preperitioneal laparoscopic herniorrhaphy (TAPP) in treating inguinal hernia.
      Methods  A total of 82 patients with inguinal hernia admitted to our hospital were randomly divided into control group(n=41) and observation group(n=41). The control group implemented tension-free hernioplasty, while the observation group was given transabdominal preperitioneal laparoscopic herniorrhaphy. The situation of surgery, the incidence of postoperative complications, postoperative recovery, hospitalization expenses, postoperative pain scores, serum inflammatory factors index, postoperative recurrence rate were compared.
      Results  The operative time of the observation group was shorter, and the intraoperative blood loss was less than that of the control group (P < 0.05). Compared with the control group, the total incidence of postoperative complications in the observation group was lower, recovery time of postoperative exhaust, hospitalization time were shorter, and the hospitalization cost was less than those in the control group (P < 0.05). Compared with the control group, the pain scores at 8, 12, 24 and 48 h after surgery in the observation group were all lower than that of the control group (P < 0.05). The serum inflammatory factor index Creactive protein (CRP), interleukin-6 (IL-6), procalcitonin (PCT) levels in the observation group were significantly lower than those in the control group (P < 0.05). There was no significant difference in recurrence rate during 6-month follow-up period between the two groups (P>0.05).
      Conclusion  TAPP can effectively alleviate the surgical trauma of patients with inguinal hernia, accelerate the postoperative recovery, and reduce the economic burden of patients.

     

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