[1]黄 靖.腹膜外腔镜无张力和开放式无张力疝修补术治疗腹股沟疝的临床效果[J].医学信息,2024,37(23):50-53.[doi:10.3969/j.issn.1006-1959.2024.23.011]
　HUANG Jing.Clinical Effect of Totally Extraperitoneal Prosthetic and Open Tension-free Hernioplasty in the Treatment of Inguinal Hernia[J].Journal of Medical Information,2024,37(23):50-53.[doi:10.3969/j.issn.1006-1959.2024.23.011]
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腹膜外腔镜无张力和开放式无张力疝修补术治疗腹股沟疝的临床效果()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
37卷
期数:
2024年23期
页码:
50-53
栏目:
论著
出版日期:
2024-12-01

文章信息/Info

Title:
Clinical Effect of Totally Extraperitoneal Prosthetic and Open Tension-free Hernioplasty in the Treatment of Inguinal Hernia
文章编号:
1006-1959（2024）23-0050-04
作者:
黄 靖
赣州市南康区中医院外一科，江西 赣州 341400
Author(s):
HUANG Jing
Department of Surgery,Nankang District Hospital of Traditional Chinese Medicine,Ganzhou 341400,Jiangxi,China
关键词:
腹膜外腔镜无张力疝修补术; 开放式无张力疝修补术; 术中出血; 应激反应; 术后疼痛
Keywords:
Totally extraperitoneal prosthetic; Open tension-free hernioplasty; Intraoperative bleeding; Stress response; Postoperative pain
分类号:
R656.21
DOI:
10.3969/j.issn.1006-1959.2024.23.011
文献标志码:
A
摘要:
目的 研究腹膜外腔镜无张力疝修补术（TEP）与开放式无张力疝修补术治疗腹股沟疝的临床效果。方法 选取2021年9月-2023年8月赣州市南康区中医院收治的70例腹股沟疝患者，行随机数字表法分为TEP组（35例）和开放组（35例）。TEP组开展腹膜外腔镜无张力疝修补术治疗，开放组则应用开放式无张力疝修补术治疗，比较两组手术指标（手术时间、术中出血量、术后下床活动时间、术后住院时间）、围术期应激指标[心率（HR）、平均动脉压（MAP）]、术后疼痛程度[视觉模拟评分（VAS）]及并发症发生情况。结果 TEP组手术时间、术后下床活动时间、术后住院时间均短于开放组，且术中出血量少于开放组（P＜0.05）；两组术中、术后应激指标（HR、MAP）均高于术前，但TEP组术中、术后应激指标（HR、MAP）低于开放组（P＜0.05）；TEP组术后2 h、6 h的VAS评分低于开放组（P＜0.05）；TEP组术后并发症发生率小于开放组（P＜0.05）。结论 相较于开放式无张力疝修补术，TEP术治疗腹股沟疝的临床优势更为明显，其手术时间更短、术中出血更少、术后恢复更快，患者围术期应激反应轻，疼痛度低，外科并发症风险小，值得应用。
Abstract:
Objective To study the clinical effect of totally extraperitoneal prosthetic (TEP) and open tension-free hernioplasty in the treatment of inguinal hernia.Methods Seventy patients with inguinal hernia admitted to GanzhouNankang District Hospital of Traditional Chinese Medicine from September 2021 to August 2023 were selected and divided into TEP group (35 patients) and open group (35 patients) by random number table method. The TEP group was treated with totally extraperitoneal prosthetic repair, while the open group was treated with open tension-free hernioplastyrepair. The operation indexes (operation time, intraoperative blood loss, postoperative ambulation time, postoperative hospitalization time), perioperative stress indexes [heart rate (HR), mean arterial pressure (MAP)], postoperative pain degree [Visual Analogue Scale (VAS)] and complications were compared between the two groups.Results The operation time, postoperative ambulation time and postoperative hospital stay in the TEP group were shorter than those in the open group, and the intraoperative blood loss was less than that in the open group (P<0.05). The intraoperative and postoperative stress indexes (HR, MAP) in the two groups were higher than those before operation, but the intraoperative and postoperative stress indexes (HR, MAP) in the TEP group were lower than those in the open group (P<0.05). The VAS score at 2 h and 6 h after operation in the TEP group were lower than that in the open group (P<0.05). The incidence of postoperative complications in the TEP group was lower than that in the open group (P<0.05).Conclusion Compared with open tension-free hernioplasty, TEP has more obvious clinical advantages in the treatment of inguinal hernia. It has shorter operation time, less intraoperative bleeding, faster postoperative recovery, mild perioperative stress response, low pain and low risk of surgical complications, which is worthy of application.

参考文献/References:

[1]孙瑞平,李永刚.腹腔镜疝修补术与开放式无张力疝修补术治疗成人腹股沟疝的效果及对患者应激指标影响对比[J].贵州医药,2023,47(8):1199-1200.[2]刘威,沈根海,高泉根,等.全腹膜外腹腔镜疝修补术与开放手术治疗女性腹股沟疝的比较[J].中国微创外科杂志,2023,23(5):354-358.[3]张敏剑,吴永友,钟丰云,等.腹腔镜下完全腹膜外疝修补术与经腹腔腹膜前疝修补术治疗成人单侧初发腹股沟疝的效果比较[J].中国医药导报,2023,20(10):84-87,99.[4]罗晔哲,林素琼.完全腹膜外腹腔镜疝修补术在下腹部手术史病人中的可行性研究[J].蚌埠医学院学报,2022,47(11):1560-1563.[5]王刚,杜强,樊林.TAPP术和开放式无张力疝修补术在腹股沟疝治疗中的应用价值[J].检验医学与临床,2022,19(7):913-917.[6]黄翠景,吴永丰,刘兴洲.无张力疝修补术与腹腔镜全腹膜外疝修补术治疗老年腹股沟疝的临床效果及安全性评价[J].中国医刊,2021,56(4):439-442.[7]刘嘉杰,魏妮娜,沈剑峰,等.开放与腹腔镜腹膜前腹股沟疝无张力修补术临床疗效的前瞻性非随机对照研究[J].腹腔镜外科杂志,2020,25(12):889-894.[8]吕志强,沈根海,戴玮,等.腹腔镜下完全腹膜外疝修补术治疗成人腹股沟疝:单中心1021例报道[J].临床外科杂志,2020,28(7):666-668.[9]姚敏泉,姜宇朋,易兵鸿,等.腹膜外腹腔镜疝气修补术治疗老年腹股沟疝的临床有效性探究[J].中国全科医学,2020,23(1):130-132.[10]刘波.腹膜外腹腔镜疝气修补术与传统疝修补术治疗腹股沟疝的疗效对比[J].昆明医科大学学报,2020,41(4):127-131.[11]曹亮,王步云.对比分析开放式无张力疝修补术与腹腔镜疝修补术治疗成人腹股沟疝的临床疗效[J].贵州医药,2020,44(3):410-412.[12]赵洁,吴团结,李辉.腹腔镜完全腹膜外补片植入术与常规无张力疝修补术治疗腹股沟疝患者的疗效对比[J].徐州医科大学学报,2019,39(1):26-29.[13]Chung Y,Choi JW,Kim HC,et al.Feasibility of totally extraperitoneal(TEP) laparoscopic hernia repair in elderly patients[J].Hernia,2018,23(2):299-303.[14]傅厚丰,符敏,杨河,等.腹腔镜下经腹腹膜前疝无张力修补术与传统术式治疗腹股沟疝患者近期效果比较[J].中国医药,2019,14(12):1851-1853.[15]徐进.开放式完全腹膜外疝修补术与传统无张力疝修补术治疗老年腹股沟疝比较[J].中国老年学杂志,2019,39(22):5524-5527.[16]任少勋,党涛平,王晓东.腹腔镜完全腹膜外疝修补术与开放无张力腹股沟疝术治疗腹股沟疝价值分析[J].山西医药杂志,2020,49(4):426-428.[17]陈元岩,王业增,钟俊新,等.腹腔镜经腹腹膜前疝修补术与开放无张力疝修补创伤反应的对比研究[J].腹腔镜外科杂志,2018,23(10):750-752,756.[18]梁明超,梁盛枝,吴跃锐,等.腹腔镜完全腹膜外疝修补术与疝环填充式无张力疝修补术治疗腹股沟疝疗效比较[J].海南医学,2018,29(12):1744-1746.[19]王刚,沈根海,高泉根,等.腹腔镜完全腹膜外腹股沟疝修补术与开放无张力腹股沟疝修补术治疗老年腹股沟疝的临床效果[J].中国老年学杂志,2018,38(7):1646-1648.[20]吴建林.经腹腔镜全腹膜外无张力疝修补术治疗腹股沟疝疗效观察[J].陕西医学杂志,2018,47(3):359-361.[21]Altin O,Kaya S.Comparison of Total Extraperitoneal Laparoscopic Surgery for Inguinal Hernia Repair between Elderly and Non-Elderly Patients[J].International Journal of Gerontology,2020,14(2):115-118.[22]彭宣福,王德良,王尧,等.腹腔镜疝修补术与开放式腹膜前间隙疝修补术治疗老年患者临床疗效对比[J].重庆医学,2019,48(1):297-299.

更新日期/Last Update: 1900-01-01