无张力修补术治疗老年腹股沟疝患者的临床疗效

摘要

目的 探讨无张力修补术治疗老年腹股沟疝临床效果. 方法 选取2016我院收治的124例老年腹股沟疝患者,按照随机对照法将其分为两组(研究组62例和对照组62例),对照组患者采取开放式无张力修补术治疗,研究组患者采取腹腔镜下无张力疝修补术治疗,比较不同组患者手术时间、术中出血量、术后疼痛时间、平均住院时间、术后复发率和并发症发生率. 结果 研究组患者手术时间长于对照组[(87.0±5.0)min和(55.5±4.2)min,t=-37.984,P=0.000],但在术中出血量[(19.9±2.0)ml和(36.8±2.5)ml,t=41.564,P=0.000]、术后疼痛时间[(22.1±4.2)d和(35.3±7.0)d,t=12.732,P=0.000]和平均住院时间[(5.5±1.0)d和(9.2±1.9)d,t=13.569,P=0.000]等均少于对照组;研究组患者术后疾病复发率低于对照组(0.0％和6.5％,x2=4.133,P=0.042).研究组患者术后并发症发生率均低于对照组(3.2％和12.9％,x2=3.916,P=0.048).结论 腹腔镜下无张力疝修补术在治疗腹股沟疝方面临床疗效确切,术后疾病住院时间短和并发症发生率少,其值得推广借鉴.%Objective To explore the clinical effect of tension-free repair in the treatment of inguinal hernia in elderly patient.Methods A total of 124 elderly patients with inguinal hernia admitted in our hospital in 2016 were randomly divided into a study group(n=62)and a control group (n=62).The control group was treated with open tension-free inguinal hernia repair,whereas with laparoscopic tension-free inguinal hernia repair in the study group.The operation time,intraoperative blood loss,the postoperative pain relief-time,mean days of hospitalization,postoperative recurrence rate,and complications rates were compared between the two groups.Results The more significant improvements were found in study group versus control group in the intraoperative bleeding volume [(19.9±2.0)ml vs.(36.8±-2.5)ml,t=41.564,P=0.000],in the mean hours of postoperative pain [(22.1 ± 4.2) h vs.(35.3 ± 7.0) h,t =12.732,P =0.000],in mean days of hospitalization [(5.5 ± 1.0)d vs.(9.2±1.9)d,t=13.569,P=0.000],in incidence rate of postoperative recurrence(0.0％ vs.6.5％,x2 =4.133,P=0.042),and in postoperative complications rate(3.2％ vs.12.9％,x2 =3.916,P=0.048).Nevertheless,the operation time was longer in the study group than in the control group[(87.0±5.0)min vs.(55.5±4.2)min,t=-37.984,=0.000],Conclusions As compared with open tension-free repair,the clinical efficacy of laparoscopic tension-free hernia repair is exactly sure in the treatment of inguinal hernia,with shorter postoperative hospitalization time and lower incidence of complications.