不同方式的腹股溝疝腹膜前無張力疝修補(bǔ)術(shù)的臨床對比研究

洪紹昆

[摘要] 目的 不同方式的腹膜前無張力疝修補(bǔ)術(shù)治療腹股溝疝的臨床對比研究。 方法 方便選取該院2017年1月—2018年1月收治的114例腹股溝疝患者，隨機(jī)分為觀察組（n=57）和對照組（n=57），觀察組行腹腔鏡完全腹膜外疝修補(bǔ)術(shù)（TEP）治療，對照組行開腹腹膜前網(wǎng)片植入術(shù)治療，對比兩組治療效果，包括治療有效率、住院時(shí)間、并發(fā)癥發(fā)生率3個(gè)方面。 結(jié)果 觀察組患者住院時(shí)間平均（1.3±0.2）d，對照組為（2.2±0.5）d，組間差異有統(tǒng)計(jì)學(xué)意義（t=11.547，P<0.05），觀察組并發(fā)癥發(fā)生率3.50%，對照組為21.04%，組間差異有統(tǒng)計(jì)學(xué)意義（χ2=22.825，P<0.05）。兩組治療有效率均較為100.00%，差異無統(tǒng)計(jì)學(xué)意義（χ2=0.003，P>0.05）。 結(jié)論 與開腹腹膜前網(wǎng)片植入術(shù)相比，行腹腔鏡完全腹膜外疝修補(bǔ)術(shù)治療腹股溝疝結(jié)果較理想，能夠保證手術(shù)效果，也能控制并發(fā)癥，后續(xù)臨床工作中可予以推廣。

[關(guān)鍵詞] 腹腔鏡;開腹腹膜前修補(bǔ)術(shù);腹股溝疝;術(shù)后感染

[中圖分類號(hào)] R5? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] A? ? ? ? ? [文章編號(hào)] 1674-0742（2019）05（a）-0055-03

[Abstract] Objective To compare the clinical effects of different kinds of preperitoneal tension-free hernioplasty in the treatment of inguinal hernia. Methods A total of 114 patients with inguinal hernia admitted to our hospital from January 2017 to January 2018 were convenient selected and divided into two groups： observation group（n=57） and control group （n=57）. The observation group was treated with laparoscopic total extraperitoneal hernia repair（TE）， while the control group was treated with open preperitoneal mesh implantation. The therapeutic effects of the two groups were compared， including therapeutic effectiveness， safety， hospitalization time and incidence of complications. Results The average hospitalization time of the patients in the observation group was （1.3±0.2） days， and that of the control group was （2.2±0.5） days. There was a significant difference between the two groups （t=11.547，P<0.05）. The incidence of complications in the observation group was 3.50%， and that in the control group was 21.04%. There was a significant difference between the two groups （χ2=22.825，P<0.05）. The effective rate of the two groups was 100.00%， the difference was not significant （χ2=0.003，P>0.05）. Conclusion Compared with open preperitoneal mesh implantation， laparoscopic total extraperitoneal herniorrhaphy for inguinal hernia has a better result， which can ensure the operation effect and control complications. It can be popularized in the follow-up clinical work.

[Key words] Laparoscopy; Open preperitoneal repair; Inguinal hernia; Postoperative infection

腹股溝疝（inguinal hernia）是一種較為常見的普通外科疾病，男性發(fā)病率高于女性，多指腹腔內(nèi)組織通過腹股溝區(qū)的缺損，向體表突出形成的組織隆起、包塊，可分為直疝、斜疝兩種。該疾病不會(huì)直接威脅患者生命安全，但存在疝內(nèi)容物嵌頓的可能，需及時(shí)治療。目前各地普遍以外科手術(shù)方式進(jìn)行處理。腹腔鏡完全腹膜外疝修補(bǔ)術(shù)（TEP）及開腹腹膜前修補(bǔ)術(shù)為臨床用于治療腹股溝疝的兩種常見術(shù)式，研究指出不同手術(shù)方法下，最終的治療效果存在差異，該院方便選取2017年1月—2018年1月收治的114例腹股溝疝患者，針對相關(guān)內(nèi)容進(jìn)行了調(diào)查，現(xiàn)報(bào)道如下。

1? 資料與方法

1.1? 一般資料