不同加压方式在腹腔镜下腹股沟疝无张力修补术后的应用及对血清肿的预防分析

doi:10.3877/cma.j.issn.1674-392X.2026.04.015

目的

观察不同加压方式在腹腔镜下腹股沟疝无张力修补术后的应用及对血清肿的预防。

方法

选取2023年2月至2025年2月苏州市立医院收治的100例腹股沟疝患者，均行腹腔镜下腹股沟疝无张力修补术，按随机数字表法分为对照组和观察组，每组患者50例。对照组患者术后使用盐袋常规加压，观察组术后使用新型疝穿戴装置（HWD）加压，比较2组患者术后血清肿发生情况、视觉模拟评分法（visual analogue scale，VAS）评分及卡罗莱纳舒适量表（CCS）评分。

结果

术后1周、术后1个月，观察组血清肿发生率为4.00%和2.00%，低于对照组的12.00%和6.00%，但2组差异无统计学意义（P>0.05）。术后6、12、24 h，观察组VAS评分为（3.12±0.43）分、（2.28±0.30）分、（1.69±0.22）分，低于对照组的（3.82±0.51）分、（3.02±0.45）分、（2.41±0.39）分，2组差异均有统计学意义（P<0.05）。术后1周，观察组CCS评分为（22.03±6.59）分，低于对照组的（26.77±8.24）分，2组差异有统计学意义（P<0.05）。

结论

腹股沟疝患者腹腔镜下腹股沟疝无张力修补术后使用HWD较传统盐袋压迫方法，可降低血清肿发生率，减轻术后疼痛，提高生活质量，值得临床推广应用。

关键词: 疝，腹股沟, 疝修补术, 腹腔镜, 疝穿戴装置, 血清肿

Objective

To observe the application of different compression methods after laparoscopic tension-free inguinal hernia repair and their preventive effects on seroma.

Methods

A total of 100 patients who underwent laparoscopic tension-free inguinal hernia repair at Suzhou Municipal Hospital from February 2023 to February 2025 were selected. They were divided into a control group and an observation group with 50 cases in each group using the random number table method. After surgery, the control group received conventional compression with a salt bag, while the observation group received compression with a novel hernia wearable device (HWD). Occurrence of seroma, the visual analogue scale (VAS) score and the Carolina comfort scale (CCS) score were compared between the two groups.

Results

At 1 week and 1 month after surgery, the incidence of seroma in the observation group was 4.00% and 2.00%, respectively, which was lower than 12.00% and 6.00% in the control group. However, there was no statistically significant difference between the two groups (P>0.05). At 6, 12, 24 after surgery, VAS scores of the observation group [(3.12±0.43) points, (2.28±0.30) points, (1.69±0.22) points] were lower than those of the control group [(3.82±0.51) points, (3.02±0.45) points, (2.41±0.39) points], with statistically significant difference (P<0.05). One week after surgery, CCS score of the observation group (22.03±6.59 points) was lower than that of the control group (26.77±8.24) points, with statistically significant difference (P<0.05).

Conclusion

Compared to conventional compression with a salt bag, compression with a HWD after laparoscopic tension-free inguinal hernia repair can reduce the incidence of seroma, alleviate postoperative pain and improve quality of life. It is worthy of clinical promotion and application.

Key words: Hernia, inguinal, Herniorrhaphy, Laparoscopes, Hernia wearable device, Seroma

图1 新型疝穿戴装置

表1 2组腹股沟疝患者血清肿发生率比较[例（%）]

组别	例数	术后1周	术后1个月
对照组	50	6(12.00)	3(6.00)
观察组	50	2(4.00)	1(2.00)
χ²值		3.314	1.895
P值		0.069	0.169

表1 2组腹股沟疝患者血清肿发生率比较[例（%）]

组别	例数	术后1周	术后1个月
对照组	50	6(12.00)	3(6.00)
观察组	50	2(4.00)	1(2.00)
χ²值		3.314	1.895
P值		0.069	0.169

表2 2组腹股沟疝患者VAS评分比较（分，

±s）

组别	例数	术后6 h	术后12 h	术后24 h	术后48 h
对照组	50	3.82±0.51	3.02±0.45	2.41±0.39	1.23±0.14
观察组	50	3.12±0.43	2.28±0.30	1.69±0.22	1.18±0.10
t值		7.420	9.675	11.370	1.908
P值		<0.001	<0.001	<0.001	0.060

表2 2组腹股沟疝患者VAS评分比较（分，

±s）

组别	例数	术后6 h	术后12 h	术后24 h	术后48 h
对照组	50	3.82±0.51	3.02±0.45	2.41±0.39	1.23±0.14
观察组	50	3.12±0.43	2.28±0.30	1.69±0.22	1.18±0.10
t值		7.420	9.675	11.370	1.908
P值		<0.001	<0.001	<0.001	0.060

表3 2组腹股沟疝患者CCS评分比较（分，

±s）

组别	例数	异物感	疼痛	活动受限	总分
对照组	50	9.82±2.44	9.05±2.23	7.90±1.95	26.77±8.24
观察组	50	8.95±2.31	6.38±2.00	6.70±1.41	22.03±6.59
t值		1.831	6.303	3.526	3.177
P值		0.070	<0.001	0.001	0.002

表3 2组腹股沟疝患者CCS评分比较（分，

±s）

组别	例数	异物感	疼痛	活动受限	总分
对照组	50	9.82±2.44	9.05±2.23	7.90±1.95	26.77±8.24
观察组	50	8.95±2.31	6.38±2.00	6.70±1.41	22.03±6.59
t值		1.831	6.303	3.526	3.177
P值		0.070	<0.001	0.001	0.002

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Application of different compression methods after laparoscopic tension-free inguinal hernia repair and their preventive effects on seroma

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Application of different compression methods after laparoscopic tension-free inguinal hernia repair and their preventive effects on seroma