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腹膜外腹腔镜疝气修补术治疗老年腹股沟疝疗效观察
作者:杨云广 魏留田 
单位:(河南省濮阳市妇幼保健院外科 濮阳 457000) 
关键词:腹膜外腹腔镜疝气修补术 腹股沟疝 传统疝修补术 并发症 复发 
分类号:R683
出版年,卷(期):页码:2019,47(8):591-594
摘要:

目的 观察腹膜外腹腔镜疝气修补术(TEP)治疗老年腹股沟疝的临床疗效。方法 选取2016年10月~2017年10月收治的老年腹股沟斜疝患者124例,根据手术方式分组,采用TEP治疗的患者作为A组(62例),采用传统疝修补术治疗的患者作为B组(62例),比较两组的手术情况、术后疼痛情况、并发症和复发率。结果 A组手术成功率为100%,B组有2例中转开放手术,2例中转开腹手术,手术成功率为93.55%,两组手术成功率比较差异无统计学意义(χ2=2.352,P=0.177)。A组手术时间、下床活动时间和住院时间短于B组,术中出血量少于B组(P<0.01)。两组术前VAS评分比较,差异无统计学意义(P>0.05);两组术后6 h、12 h、24 h的VAS评分与治疗前相比均显著下降(P<0.05),且A组的下降幅度较B组大(P<0.01)。术后随访6个月, A组总并发症发生率显著低于B组(P<0.05)。A组无一例复发,B组复发6例,占9.68%,两组比较差异有统计学意义(χ2=4.379,P=0.036)。结论 与传统疝修补术相比,TEP具有成功率高、疗效好、术后并发症少、复发率低的优点,值得推广应用。

Objective To observe the clinical efficacy of laparoscopic totally extraperitoneal prosthesis(TEP) for elderly patients with inguinal hernia.Methods 124 patients with inguinal hernia admitted to hospital from October 2016 to October 2017 were selected and divided into groups according to surgical methods.Group A(62 cases) were given TEP,and group B(62 cases) were given traditional hernia repair.And then,operative conditions,postoperative pain,complications and recurrence rates were compared between the two groups.Results The surgical success rate of the group A was 100%,and that of the group B was 93.55%(2 cases in the group B were converted to open operation,and 2 cases were converted to laparotomy),difference was not statistically significant(χ2=2.352,P=0.177).The time of operation,the time of getting out of bed and the time of hospitalization in the group A were shorter than those in the group B,and the amount of intraoperative blood loss in the group A was less than that in the group B(P<0.01).There was no statistically significant difference in VAS scores between the two groups before operation(P>0.05).6 h,12 h and 24 h after operation,the VAS scores of the two groups decreased significantly(P<0.05),and the decrease in the group A was larger than that in the group B(P<0.01).After 6 months of follow-up,the incidence of total complication in the group A was significantly lower than that in the group B(P<0.05).There was no recurrence in the group A and 6 cases of recurrence in the group B(9.68%),difference was statistically significant(χ2=4.379,P=0.036).Conclusion Compared with traditional hernia repair,TEP has the advantages of high success rate,good curative effect,few postoperative complications and low recurrence rate.It is worth promoting and applying.

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