腹膜外腹腔镜无张力疝修补术治疗腹股沟疝的临床疗效及安全性

摘要

Objective To investigate the clinical effect and safety oflaparoscopic extraperitoneal tension-free hernia repair in the treatment of inguinal hernia.Methods The patients with inguinal hernia who were treated in Nanjing First Hospital from January 2016 to December 2017 were randomly divided into the study group (laparoscopic extraperitoneal tension-free hernia repair,n=84) and the control group (open tension-free hernia repair,n=84).The operation time,bleeding volume and hospitalization time of the two groups were compared and analyzed.The time of first ambulation (h),complications (wound infection,urinary retention,hematoma) and pain (VAS) scores on the 1st and 3rd day after operation.Results The operation time,hospitalization time and first time out of bed activity time of the study group were shorter than those of the control group,and the differences were statistically significant (P＜0.05).The amount of intraoperative bleeding of the study group was less than that of the control group,and the difference was statistically significant (P＜0.05).The incidences of incision infection,hematoma and urinary retention in the study group were lower than those in the control group,and the overall incidence was lower than that in the control group (P＜0.05).The VAS scores of the study group on the 1st and 3rd day after operation were significantly lower than those in the control group (P＜0.05).Conclusion Laparoscopic extraperitoneal tension-free hernia repair has a good clinical effect in the treatment of inguinal hernia,and it can reduce the incidence of postoperative complications,which is worthy of clinical application.%目的 探讨腹膜外腹腔镜无张力疝修补术治疗腹股沟疝患者的临床效果及安全性.方法 纳入2016年1月至2017年12月,南京市第一医院行腹膜外腔镜腹股沟疝修补术患者84例,同期行开放式无张力疝修补术患者84例,对比分析2组手术时间、出血量、术后住院时间、术后首次下床活动时间、手术并发症情况(手术伤口感染、尿潴留、血肿)、术后第1、3天的视觉模拟评分法(visual analogue scale,VAS)评分.结果 试验组患者的手术时间、术后住院时间、术后首次下床活动时间均短于对照组,差异均有统计学意义(P＜0.05),试验组术中出血量少于对照组,差异有统计学意义(P＜0.05).试验组术后手术切口感染发生率、血肿发生率、尿潴留发生率均低于对照组,总体发生率低于对照组,差异有统计学意义(P＜0.05),试验组术后第1、3天的VAS评分均显著低于对照组,差异有统计学意义(P＜0.05).结论 腹膜外腹腔镜无张力疝修补术在治疗腹股沟疝具有较好的临床效果,可显著降低术后并发症发生率.