腹腔镜下修补术与开放式无张力修补术在老年腹股沟疝的疗效比较

doi:10.3877/cma.j.issn.1674-392X.2018.01.008

中华疝和腹壁外科杂志(电子版) ›› 2018, Vol. 12 ›› Issue (01) : 34 -37. doi: 10.3877/cma.j.issn.1674-392X.2018.01.008

所属专题：文献；

论著

腹腔镜下修补术与开放式无张力修补术在老年腹股沟疝的疗效比较

梁永辉¹, 磨鹏诗¹^,^†(

), 廖伟明¹, 陈应驹¹, 刘达¹, 高向林¹, 吴振声¹, 何宇晖¹

^1. 528315　广东佛山，广州医科大学附属顺德医院外二科

收稿日期:2017-11-20 出版日期:2018-02-15
通信作者: 磨鹏诗

Comparative analysis of the effect and safety of laparoscopic repair and open tension-free repair for inguinal hernia in elderly patients

Yonghui Liang¹, Pengshi Mo¹^,^†(), Weiming Liao¹, Yingju Chen¹, Da Liu¹, Xianglin Gao¹, Zhensheng Wu¹, Yuhui He¹

^1. Department of Second Surgery, Shunde Affiliated Hospital of Guangzhou Medical University, Foshan 528315, China

Received:2017-11-20 Published:2018-02-15
Corresponding author: Pengshi Mo
About author:
Corresponding author: Mo Pengshi, Email: drmouse@163.com

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目的

对比分析腹腔镜下修补术与开放式无张力修补术在老年腹股沟疝中的效果及安全性。

方法

选取2015年7月至2017年1月，广州医科大学附属顺德医院收治的老年腹股沟疝患者118例，根据治疗方法不同分为研究组及对照组，每组患者59例。研究组行腹腔镜下疝修补术，对照组行开放式无张力疝修补术。分析2组手术状况、术后疼痛及并发症发生情况。

结果

研究组手术时间[（41.42±10.69）min比（48.75±11.62）min]、住院时间[（6.63±1.61）d比（7.28±1.53）d]及术后卧床时间[（2.45±1.06）d比（4.37±2.95）d]均显著短于对照组，术中出血量[（18.15±5.49）ml比（22.03±3.54）ml]少于对照组，但住院费用[（11 022.56±1 598.07）比（6 023.20±1 002.15）]高于对照组，差异均有统计学意义（P均<0.05）；与术前比较，2组术后1、3、5 d视觉模拟评分（visual analogue scale，VAS）均显著下降，研究组各时间点VAS评分（3.65±0.72、2.56±1.49、1.70±0.13）均显著低于对照组（4.83± 0.50、3.64±1.32、2.86±1.24），差异均有统计学意义（P均<0.05）；术后研究组并发症发生率为6.67%，显著低于对照组的17.24%，差异有统计学意义（P<0.05）。

结论

与开放式无张力修补术相比，腹腔镜下修补术可有效减少出血、缩短手术时间、住院时间及卧床时间等，经济可行，安全性更好，且患者疼痛感更小。

关键词: 疝，腹股沟, 疝修补术, 腹腔镜

Objective

Compare the effect and safety of laparoscopic repair and open tension-free repair for inguinal hernia in elderly patients.

Methods

118 cases of elderly patients with inguinal hernia in Shunde affiliated hospital of Guangzhou Medical University were selected and divided into study group and control group according to the different treatment methods, with 59 cases in each group. Study group was treated with laparoscopic repair, while control group was treated with open tension-free repair. The operation details, postoperative pain and complications of the 2 groups were analyzed.

Results

The operation time, length of hospital stay and postoperative bed time of study group were shorter than those of control group. The amount of bleeding during operation of study group was less than that of the control group, while the hospitalization cost was higher (P<0.05); Compared with preoperative pain, the VAS scores at 1st, 3th and 5th day of 2 groups after surgery were significantly decreased, and the VAS scores of the study group were significantly lower than those of the control group at each time point (P<0.05); The postoperative complication rate of the study group was 6.67%, which was significantly lower than that of the control group (17.24%), the difference was statistically significant (P<0.05).

Conclusion

Compared with open tension-free repair, laparoscopic repair is feasible and safe, can reduce bleeding effectively and postoperative pain, shorten the operation time, length of hospital stay and postoperative bed time.

Key words: Hernia, inguinal, Herniorrhaphy, Laparoscopes

表1 2组手术相关指标比较（±s）

组别	例数	手术时间(min)	术中出血量(ml)	住院时间(d)	术后卧床时间(d)	住院费用(元)
研究组	60	41.42±10.69^a	18.15±5.49^a	6.63±1.61^a	2.45±1.06^a	11 022.56±1 598.07^a
对照组	58	48.75±11.62	22.03±3.54	7.28±1.53	4.37±2.95	6 023.20±1 002.15

表1 2组手术相关指标比较（±s）

组别	例数	手术时间(min)	术中出血量(ml)	住院时间(d)	术后卧床时间(d)	住院费用(元)
研究组	60	41.42±10.69^a	18.15±5.49^a	6.63±1.61^a	2.45±1.06^a	11 022.56±1 598.07^a
对照组	58	48.75±11.62	22.03±3.54	7.28±1.53	4.37±2.95	6 023.20±1 002.15

表2 2组手术前后视觉模拟评分比较（分，±s）

组别	例数	术前	术后1 d	术后3 d	术后5 d
研究组	60	5.69±2.04	3.65±0.72^ab	2.56±1.49^ab	1.70±0.13^ab
对照组	58	5.72±2.13	4.83±0.50^a	3.64±1.32^a	2.86±1.24^a

表2 2组手术前后视觉模拟评分比较（分，±s）

组别	例数	术前	术后1 d	术后3 d	术后5 d
研究组	60	5.69±2.04	3.65±0.72^ab	2.56±1.49^ab	1.70±0.13^ab
对照组	58	5.72±2.13	4.83±0.50^a	3.64±1.32^a	2.86±1.24^a

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Comparative analysis of the effect and safety of laparoscopic repair and open tension-free repair for inguinal hernia in elderly patients

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Comparative analysis of the effect and safety of laparoscopic repair and open tension-free repair for inguinal hernia in elderly patients