气带压迫对腹腔镜经腹腹膜前疝修补术后血清肿的影响

doi:10.3877/cma.j.issn.1674-392X.2025.06.013

目的

探讨疝气带压迫治疗对降低腹股沟斜疝患者腹腔镜经腹腹膜前疝修补术（TAPP）后血清肿发生率的疗效。

方法

选取2021年5月至2022年5月于桐乡市第一人民医院接受TAPP术的男性成人腹股沟斜疝50例患者进行回顾性分析，随机分为试验组和对照组，2组均行TAPP术式。试验组术后腹股沟区予疝气带压迫治疗1周，对照组术后常规予沙袋压迫12 h，对比分析2组患者的一般资料、疝环缺损大小、疝囊是否完整剥除、手术时间、术中出血量、术后住院时间、术后血清肿的发生率、血清肿分型和疝复发率。

结果

2组患者的一般资料、术中相关资料、术后住院时间比较，差异均无统计学意义（均P>0.05）。试验组术后血清肿发生率为8%，其中Ⅲ型血清肿的发生率为0%，对照组术后血清肿发生率为32%，其中Ⅲ型血清肿的发生率16%，两组间差异均有统计学意义（P<0.05）；对照组4例血清肿患者经穿刺引流后治愈，随访期间2组患者均无疝复发。

结论

腹股沟斜疝患者行TAPP术后，通过疝气带压迫治疗，能有效降低术后血清肿的发生率，安全性好，取得了令人满意的近期效果，具有良好的临床应用前景。

关键词: 腹腔镜, 疝，腹股沟, 疝气带, 血清肿

Objective

To investigate the efficacy of truss compression therapy in reducing the incidence of postoperative seroma in patients with indirect inguinal hernia undergoing laparoscopic transabdominal preperitoneal (TAPP) repair.

Methods

From May 2021 to May 2022, 50 adult male patients with indirect inguinal hernia who underwent TAPP at the Tongxiang First People's Hospital were selected and randomly divided into an experimental group and a control group. Both groups received the same TAPP procedure. In the experimental group, a truss was applied to compress the inguinal region for one week postoperatively; in the control group, routine sandbag compression was applied for 12 hours after surgery. The two groups were compared in terms of baseline characteristics, size of the hernia ring defect, whether the hernia sac was completely dissected, operative time, intraoperative blood loss, postoperative hospital stay, incidence and classification of postoperative seroma, and hernia recurrence rate.

Results

There were no statistically significant differences between the two groups in baseline characteristics, intraoperative parameters, or length of postoperative hospital stay (all P>0.05). The incidence of postoperative seroma was 8% in the experimental group, with no cases of type III seroma; in contrast, the control group had a 32% incidence of postoperative seroma, including a 16% incidence of type III seroma, and these differences were statistically significant (P<0.05). Four cases of seroma in the control group were cured after aspiration and drainage. No hernia recurrence was observed in either group during follow-up.

Conclusion

For patients with indirect inguinal hernia undergoing TAPP, postoperative truss compression can effectively reduce the incidence of seroma, with good safety and definite efficacy. It has achieved satisfactory short-term results in clinical practice and shows promising prospects for clinical application.

Key words: Laparoscopes, Hernia, inguinal, Trusses, Seroma

表1 2组患者一般资料比较

组别	例数	年龄(岁, ± s)	体重指数(kg/m², ± s)	疝位置[例(%)]
组别	例数	年龄(岁, ± s)	体重指数(kg/m², ± s)	左侧	右侧
试验组	25	55.4±16.2	23.4±3.4	10(40.0)	15(60)
对照组	25	55.0±15.6	23.5±3.1	9(36)	16(64)
t/χ²值		0.107	0.139	0.085
P值		0.915	0.890	0.771

表1 2组患者一般资料比较

组别	例数	年龄(岁, ± s)	体重指数(kg/m², ± s)	疝位置[例(%)]
组别	例数	年龄(岁, ± s)	体重指数(kg/m², ± s)	左侧	右侧
试验组	25	55.4±16.2	23.4±3.4	10(40.0)	15(60)
对照组	25	55.0±15.6	23.5±3.1	9(36)	16(64)
t/χ²值		0.107	0.139	0.085
P值		0.915	0.890	0.771

表2 2组患者围手术期资料比较

组别	例数	疝环缺损大小[例(%)]		疝囊处理[例(%)]		手术时间(min, ± s)	术中出血量(ml, ± s)	术后住院时间(d, ± s)	血清肿分型[例(%)]
组别	例数	>3 cm	≤3 cm	剥除	离断	手术时间(min, ± s)	术中出血量(ml, ± s)	术后住院时间(d, ± s)	总数	Ⅰ型	Ⅱ型	Ⅲ型
试验组	25	15(60.0)	10(40.0)	20(80.0)	5(20.0)	61.4±12.6	6.8±4.4	2.5±1.0	2(8.0)	1(4.0)	1(4.0)	0(0.0)
对照组	25	13(52.0)	12(48.0)	21(84.0)	4(16.0)	62.5±10.5	6.6±4.1	2.7±1.2	8(32.0)	2(4.0)	2(8.0)	4(16.0)
χ²/t值		0.325		0.136		0.317	0.200	0.507	4.500	0.355	0.355	4.348
P值		0.569		0.713		0.752	0.842	0.614	0.034	0.552	0.552	0.037

表2 2组患者围手术期资料比较

组别	例数	疝环缺损大小[例(%)]		疝囊处理[例(%)]		手术时间(min, ± s)	术中出血量(ml, ± s)	术后住院时间(d, ± s)	血清肿分型[例(%)]
组别	例数	>3 cm	≤3 cm	剥除	离断	手术时间(min, ± s)	术中出血量(ml, ± s)	术后住院时间(d, ± s)	总数	Ⅰ型	Ⅱ型	Ⅲ型
试验组	25	15(60.0)	10(40.0)	20(80.0)	5(20.0)	61.4±12.6	6.8±4.4	2.5±1.0	2(8.0)	1(4.0)	1(4.0)	0(0.0)
对照组	25	13(52.0)	12(48.0)	21(84.0)	4(16.0)	62.5±10.5	6.6±4.1	2.7±1.2	8(32.0)	2(4.0)	2(8.0)	4(16.0)
χ²/t值		0.325		0.136		0.317	0.200	0.507	4.500	0.355	0.355	4.348
P值		0.569		0.713		0.752	0.842	0.614	0.034	0.552	0.552	0.037

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Effect of trusses compression on seroma after laparoscopic transabdominal preperitoneal hernia repair

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Effect of trusses compression on seroma after laparoscopic transabdominal preperitoneal hernia repair