探讨完全剥离疝囊与横断处理疝囊在腹腔镜经腹腹膜前疝修补术（TAPP）中的应用效果。

选择2016年7月至2018年6月，如皋市中医院行TAPP的患者120例，分为试验组和对照组各60例。试验组行横断疝囊处理试验组，对照组行完全剥离疝囊。观察并比较2组患者的手术/住院相关指标、生活质量及术后并发症发生情况。

试验组患者的手术时间、术中出血量、疝囊处理时间、术后5 d腹股沟积液、住院费用及术后第2天的疼痛视觉模拟评分（VAS）分别为（47.11±4.15）min、（3.24±1.01）ml、（9.57±2.74）min、（5.27±1.09）ml、（8 105.69± 251.67）元及（2.11±0.97）分均低于对照组（57.69±5.28）min、（6.71±2.14）ml、（25.13±4.29）min、（13.75±3.56）ml、（11 241.55±397.52）元及（4.59±1.13）分，差异具有统计学意义（t=12.203、11.359、23.678、17.643、51.628、12.899，P均<0.001）；试验组患者的住院时间（6.51±1.04）d与对照组（6.19±1.06）d比较，差异无统计学意义（t=1.669，P>0.05）；术后6个月，试验组患者的健康状况调查简表（SF-36）评分及巴塞尔指数（BI）评分分别为（82.19±8.95）分及（83.01±7.94）分均高于对照组（75.11±8.02）分及（76.25±7.19）分，而改良Rankin量表（mRS）评分（73.19±7.02）分低于对照组（84.17±7.85）分，差异均有统计学意义（t=4.563、4.888、8.076，P均<0.001）；术后试验组患者的神经感觉异常和总的并发症发生情况分别为0及1（1.67%），显著低于对照组5（8.33%）及11（18.33%），差异均有统计学意义（χ²=5.217、9.259，P=0.022、0.002）；试验组患者血清肿发生情况为1（1.67%）与对照组6（10.00%）比较，差异无统计学意义（χ²=3.793，P=0.051）。

TAPP修补术中，与疝囊剥离相比，横断疝囊可以减少手术时间，减轻手术损伤、缓解术后疼痛，且并发症发生率较低，有助于患者康复，提高生活质量。

To compare the effect on hernia sac transection and total dissection in transperitoneal inguinal hernia repair (TAPP).

120 patients underwent TAPP from July 2016 to June 2018 in Rugao Hospital of Traditional Chinese Medicine were selected. The observation group was treated with hernia sac transection and the control group was treated with hernia sac total dissection, with 60 cases in each group. The surgical/hospitalization related indicators, quality of life and postoperative complications were observed and compared between the two groups.

The operation time, intraoperative bleeding volume, hernia sac manage time, inguinal effusion of 5 days after operation, hospitalization expenses and visual analogue score (VAS) at the 2rd day after operation in the observation group [(47.11±4.15) minutes, (3.24±1.01) ml, (9.57±2.74) minutes, (5.27±1.09) ml, (8 105.69±251.67) yuan, (2.11±0.97) scores] were lower than those in the control group [(57.69±5.28) minutes, (6.71±2.14) ml, (25.13±4.29) minutes, (13.75±3.56) ml, (11 241.55±397.52) yuan, (4.59±1.13) scores], with statistical differences (t=12.203、11.359、23.678、17.643、51.628、12.899, all P<0.001). However, there was no significant difference in hospitalization time between the two groups (t=1.669, P>0.05). In six months after the operation, the scores of Short Form Health Survey-36 (SF-36) and the Barthel Index (BI) in the observation group [(82.19±8.95) sores, (83.01±7.94) sores] were higher than those in the control group [(75.11±8.02) sores, (76.25±7.19) sores], while the score of improved Rankin scale (mRS) (73.19±7.02) sores was lower than that in the control group (84.17±7.85) sores, with statistical differences (t=4.563、4.888、8.076, all P<0.001). The incidence of neurosensory abnormalities and total complications in the observation group were 0 and 1.67% respectively, which were significantly lower than those in the control group (8.33% and 18.33%, χ²=5.217、9.259, P=0.022、0.002).

In TAPP repair, compared with hernia sac dissection, therapy of hernia sac transection can reduce operation time and operation injury, relieve postoperative pain, and the incidence of complications is lower, which is helpful for recovery and improve their quality of life.