自制中药包加压理疗裤在预防和控制腹腔镜疝修补后并发症的临床研究

doi:10.3877/cma.j.issn.1674-392X.2022.02.011

目的

分析自制中药包加压理疗裤在腹腔镜腹股沟疝修补术后并发症的防治效果。

方法

收集2019年8月至2021年8月山西省中医药研究院普外科收治的腹股沟疝患者128例，按照随机数字表法，随机分为对照组和试验组，每组患者64例。2组患者均接受腹腔镜腹股沟疝修补术。对照组术后于腹股沟区沙袋加压并穿戴传统疝气带。试验组术后穿戴我科自制中药包加压理疗裤。对比2组临床指标及并发症发生情况。

结果

试验组术后疼痛视觉模拟评分较对照组低，住院时间较对照组短，PZB服务质量量表评分较对照组高（P<0.05）。术后24 h及7 d，试验组血肿及血清肿发生率、阴囊肿胀及阴囊血肿发生率低于对照组（P<0.05）。术后30 d，2组血肿及血清肿发生率、阴囊肿胀及阴囊血肿发生率差异无统计学意义（P>0.05）。

结论

腹腔镜腹股沟修补术后穿戴中药包加压理疗裤可减轻疼痛程度，降低血肿、血清肿及阴囊肿胀等术后并发症发生率，缩短住院时间，提高干预满意度。

关键词: 疝，腹股沟, 中医外治法, 加压理疗裤, 腹腔镜, 并发症

Objective

To analyze the effect of self-made Chinese medicine package compression physiotherapy pants on the prevention and treatment of complications after laparoscopic inguinal hernia repair.

Methods

A total of 128 patients with inguinal hernia admitted to the Department of General Surgery of Shanxi Province Institute of Traditional Chinese Medicine from August 2019 to August 2021 were collected and were randomly divided into control group and experimental group according to the random number table method, with 64 patients in each group. Both groups of patients underwent laparoscopic inguinal hernia repair. In the control group, the groin area was pressurized with sandbags and traditional hernia belts were worn after the operation. The experimental group wore our department's self-made Chinese medicine package compression physiotherapy pants after the operation. The clinical indicators and complications of the two groups were compared.

Results

Compared with the control group, the experimental group had a lower postoperative VAS score, shorter hospital stay, and a higher PZB service quality score (P<0.05). 24 hours and 7 days after operation, the incidence of hematoma and seroma, scrotal swelling and scrotal hematoma were lower than those in the control group (P<0.05). There was no significant difference in the incidence of hematoma and seroma, scrotal swelling and scrotal hematoma between the two groups 30 days after operation (P>0.05).

Conclusion

After laparoscopic inguinal repair, wearing our self-made traditional Chinese medicine package compression physiotherapy pants can reduce the degree of pain, reduce the incidence of postoperative complications such as hematoma, seroma, and scrotum swelling, shorten the hospital stay, and improve intervention satisfaction.

Key words: Hernia, Inguinal, External treatment of TCM, Compression physiotherapy pants, Laparoscopes, Complications

表1 2组一般资料比较

变量		对照组(64例)	试验组(64例)	P值
性别[例(%)]				1
	男性	62(96.88)	62(96.88)
	女性	2(3.12)	2(3.12)
年龄(岁, ±s)		61.92±16.37	60.17±18.10	0.535
病程(年, ±s)		4.87±8.83	2.80±4.28	0.952
体质量指数(kg/m², ±s)		24.03±2.81	24.48±3.40	0.418
疝位置				0.285
	单侧	54(84.37)	58(90.62)
	双侧	10(15.63)	6(9.38)
疝缺损大小[例(%)]				0.273
	>3 cm	27(42.18)	21(32.81)
	≤3 cm	37(57.82)	43(67.19)
ASA评分[例(%)]				0.372
	Ⅰ级	39(60.94)	34(53.13)
	Ⅱ级	25(39.06)	30(46.87)
手术方式[例(%)]				0.365
	TAPP	14(21.87)	10(15.62)
	TEP	50(78.13)	54(84.38)
手术时间(min, ±s)		43.36±4.23	43.23±5.54	0.886

表1 2组一般资料比较

变量		对照组(64例)	试验组(64例)	P值
性别[例(%)]				1
	男性	62(96.88)	62(96.88)
	女性	2(3.12)	2(3.12)
年龄(岁, ±s)		61.92±16.37	60.17±18.10	0.535
病程(年, ±s)		4.87±8.83	2.80±4.28	0.952
体质量指数(kg/m², ±s)		24.03±2.81	24.48±3.40	0.418
疝位置				0.285
	单侧	54(84.37)	58(90.62)
	双侧	10(15.63)	6(9.38)
疝缺损大小[例(%)]				0.273
	>3 cm	27(42.18)	21(32.81)
	≤3 cm	37(57.82)	43(67.19)
ASA评分[例(%)]				0.372
	Ⅰ级	39(60.94)	34(53.13)
	Ⅱ级	25(39.06)	30(46.87)
手术方式[例(%)]				0.365
	TAPP	14(21.87)	10(15.62)
	TEP	50(78.13)	54(84.38)
手术时间(min, ±s)		43.36±4.23	43.23±5.54	0.886

表2 2组临床观察指标比较

变量		对照组(64例)	试验组(64例)	P值
VAS评分(分, ±s)
	24 h	6.77±1.44	5.22±1.66	<0.001
	7 d	2.13±1.45	1.25±1.10	0.001
	30 d	0.41±0.79	0.28±0.52	0.753
血肿和血清肿[例(%)]
	24 h	46(71.88)	26(40.63)	<0.001
	7 d	21(32.81)	8(12.50)	0.006
	30 d	2(3.12)	1(1.56)	0.559
阴囊肿胀及阴囊血肿[例(%)]
	24 h	13(20.31)	5(7.81)	0.042
	7 d	8(12.50)	2(3.12)	0.048
	30 d	0	0
住院时间(d, ±s)		7.78±2.60	6.11±1.87	<0.001
服务质量量表评分(分, ±s)		18.14±2.45	21.47±2.12	<0.001

表2 2组临床观察指标比较

变量		对照组(64例)	试验组(64例)	P值
VAS评分(分, ±s)
	24 h	6.77±1.44	5.22±1.66	<0.001
	7 d	2.13±1.45	1.25±1.10	0.001
	30 d	0.41±0.79	0.28±0.52	0.753
血肿和血清肿[例(%)]
	24 h	46(71.88)	26(40.63)	<0.001
	7 d	21(32.81)	8(12.50)	0.006
	30 d	2(3.12)	1(1.56)	0.559
阴囊肿胀及阴囊血肿[例(%)]
	24 h	13(20.31)	5(7.81)	0.042
	7 d	8(12.50)	2(3.12)	0.048
	30 d	0	0
住院时间(d, ±s)		7.78±2.60	6.11±1.87	<0.001
服务质量量表评分(分, ±s)		18.14±2.45	21.47±2.12	<0.001

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Clinical application study of self-made Chinese medicine package compression physiotherapy pants on the prevention and control of complications after laparoscopic hernia repair

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Clinical application study of self-made Chinese medicine package compression physiotherapy pants on the prevention and control of complications after laparoscopic hernia repair