三种成人腹股沟疝术式的疗效及手术对术区术后慢性疼痛影响的比较研究

doi:10.3969/j.issn.1671-7171.2021.09.015

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摘要【目的】比较腹腔镜经腹腔腹膜前疝修补术(TAPP)、腹腔镜完全腹膜外补片修补术(TEP)与 Lichtenstein 修补术(LI)治疗成人腹股沟疝的疗效及手术对术区术后慢性疼痛的影响。【方法】回顾性分析于本院2015年1月至2019年1月初次就诊手术治疗的297例腹股沟疝患者临床资料,根据手术方式的不同将其分为LI组、TAPP组、TEP组,比较三组患者的临床疗效,并比较三种术式对术区术后慢性疼痛的影响。【结果】本研究297例患者中,LI组110例,TAPP组127例,TEP组60例。三组患者的术前一般情况无明显差异。三组患者的手术时间、术中出血量、术后首次下床时间均无明显统计学差异。LI组患者的术后住院时间明显长于TAPP组及TEP组(P=0.032),术后切口脂肪液化(P=0.047)及术区慢性疼痛发生率(P=0.045)明显高于TAPP组及TEP组。【结论】与传统开放术式比较,TAPP和TEP疝修补术是治疗成人腹股沟疝的有效术式,术后康复快,且术后术区慢性疼痛发生率少,值得临床推广应用。

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	邹永红
	田瑞雪

关键词 ：疝,腹股沟/外科学, 疝,腹股沟/并发症, 疼痛,手术后, 慢性病, 治疗结果

Abstract：【Objective】 To compare the efficacy of laparoscopic transperitoneal preperitoneal hernia repair (TAPP), laparoscopic total extraperitoneal patch repair (TEP) and Lichtenstein repair (LI) in the treatment of adult inguinal hernia and the effect of operation on postoperative chronic pain. 【Methods】 The clinical data of 297 patients with inguinal hernia who underwent surgery for the first time in our hospital from January 2015 to January 2019 were analyzed retrospectively, and the clinical effects of the three groups were compared. 【Results】 Among the 297 patients in this study, there were 110 in the LI group, 127 in the TAPP group and 60 in the TEP group. There was no significant difference in preoperative general conditions among the three groups. There was no significant difference in operation time, intraoperative bleeding and the first time out of bed after operation among the three groups. The postoperative hospital stay in the LI group was significantly longer than that in the TAPP group and the TEP group (P=0.032). The postoperative time of incision fat liquefaction (P=0.047) and the incidence of chronic pain in the operation area (P=0.045) were significantly higher than those in the TAPP group and the TEP group. 【Conclusion】Compared with the traditional open operation, TAPP and TEP hernia repair are effective methods for the treatment of adult inguinal hernia. They have fast postoperative recovery and less incidence of chronic pain in the postoperative area, which is worthy of clinical application.

Key words： Hernia, Inguinal/SU Hernia, Inguinal/CO Pain, Postoperative Chronic Disease Treatment Outcome

收稿日期: 2021-07-09

中图分类号:

R656.21

引用本文:

邹永红, 田瑞雪. 三种成人腹股沟疝术式的疗效及手术对术区术后慢性疼痛影响的比较研究[J]. 医学临床研究, 2021, 38(9): 1331-1333.
ZOU Yong-hong, TIAN Rui-xue. Comparative Study on the Influence of Postoperative Chronic Pain of Three Types of Adult Inguinal Hernia Surgery and their Effects on the Operation Area. JOURNAL OF CLINICAL RESEARCH, 2021, 38(9): 1331-1333.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2021.09.015 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2021/V38/I9/1331

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