比较腹腔镜经腹腹膜前疝修补术（TAPP）、腹腔镜完全腹膜外疝修补术（TEP）、开放手术疝修补术对腹股沟疝的治疗效果。

分析2018年1月至2020年1月于安徽省合肥市庐江县人民医院普外科行腹股沟疝手术治疗90例患者的资料。依据患者所采用的手术方法不同分为开放手术疝修补术组（A组），TAPP组（B组），TEP组（C组），各30例。对比3组患者的手术时间、失血量、术后12 h视觉模拟评分法（VAS）、术后下床活动时间、医疗费用、术前及术后3 d的血清去甲肾上腺素（NE）、肾上腺素（E）、促肾上腺皮质激素（ACTH）、皮质醇（Cor）、术后并发症及复发情况。

3组患者的手术耗时，差异无统计学意义（P>0.05）。A组患者的失血量、术后12 h VAS评分、术后下床活动时间、总住院时间均高于B组和C组，B组患者的术后12 h VAS评分、术后下床活动时间高于C组，A组的医疗费用最低，B次之，且差异有统计学意义（F=58.395，-0.326，-0.326，-0.326；P<0.05）。3组术前的NE、E、ACTH及Cor差异无统计学意义（均P>0.05）。术后3 d，3组的NE、E、ACTH、Cor较术前均增高；A组术后3 d的NE、E、ACTH、Cor最高，C组最低（F=1.052，12.789，1.077，18.368，1.189，17.115，1.190，20.325；P<0.05）。3组患者的术后各类并发症的结果差异无统计学意义（χ²=3.208，P>0.05）。3组患者在术后3个月内均未出现腹股沟疝复发。

开放手术疝修补术、TAPP、TEP在腹股沟疝的治疗中各具优势，实际临床工作中需要根据患者的实际情况进行选择。

To explore the difference in the therapeutic effects of laparoscopic preperitoneal hernia repair (TAPP), laparoscopic totally extraperitoneal hernia repair (TEP), and open hernia repair on inguinal hernia.

A retrospective analysis of the data of 90 patients who underwent inguinal hernia surgery at the General Surgery Department of Lujiang County People's Hospital from January 2017 to July 2019. The patients were grouped according to the different surgical methods: 30 patients with open hernia repair were regarded as group A, 30 patients with TAPP as group B, and 30 patients with TEP as group C. Operation conditions [operation time, blood loss, postoperative 12 hours pain (VAS score), postoperative ambulation time, total hospital stay, medical expenses], stress response indexes [preoperative and postoperative 3 days serum norepinephrine (NE), epinephrine (E), corticotropin (ACTH), cortisol (Cor)], postoperative complications, and recurrence were compared among the 3 groups.

There was no statistically significant difference in operation time among the 3 groups of patients (P>0.05). The blood loss, postoperative VAS score at 12 hours, postoperative ambulation time, and total length of hospital stay in group A were higher than those of groups B and C. The postoperative VAS score at 12 hours and postoperative ambulation time in group B were higher than those of group C. The medical expenses of group A were lowest, followed by group B. The preoperative NE, E, ACTH and Cor data of the three groups were not statistically different (all P>0.05). At 3 days postoperatively, NE, E, ACTH, and Cor in the 3 groups increased; NE, E, ACTH, and Cor in group A were higher than those in group B, and NE, E, ACTH, and Cor in group B were higher than those in group C (all P<0.05). There was no significant difference in the data of various postoperative complications among the three groups (P>0.05). No recurrence within 3 months after surgery occurred.

Open hernia repair, TAPP, and TEP have their own advantages in the treatment of inguinal hernias. In actual clinical work, it is necessary to choose according to the actual situation of the patient.