双层补片无张力疝修补术治疗腹股沟疝的临床探讨.pdf

谭永辉

【摘要】 目的 觀察开放完全腹膜外腹股沟疝修补术（TEP）治疗成人腹股沟疝的临床疗效及复发情况。方法 90例成人腹股沟疝患者作为研究对象， 按照手术方式将患者分为研究组和对照组， 各

45例。对照组给予传统无张力疝修补术进行治疗， 研究组给予TEP进行治疗。术后随访1年， 比较两组患者术中指标、术后近期指标及术后远期指标， 记录围手术期并发症发生情况。结果 研究组手术时间（15.46±4.60）min、术中出血量（4.45±1.33）ml、术后自主活动时间（14.32±1.65）h、住院时间（4.32±0.35）d

均优于对照组的（25.49±4.54）min、（8.36±1.75）ml、（25.72±2.36）h、（6.75±0.40）d， 差异有统计学意义（P<0.05）。研究组的并发症发生率为6.67%低于对照组的26.67%， 研究组的1年复发率为0低于对照组的8.89%， 差异有统计学意义（P<0.05）。结论 开放TEP术和传统无张力疝修补术治疗成人腹股沟疝均具有疗效可靠、安全性好的特点， 但开放TEP术能够缩短手术时间及住院时间、降低并发症发生率、加快术后康复、降低远期复发率。

【关键词】 腹股沟疝；开放完全腹膜外腹股沟疝修补术；无张力疝修补术；疗效；复发

DOI：10.14163/j.cnki.11-5547/r.2018.14.013

Analysis of clinical efficacy and recurrence of open totally extraperitoneal prosthetic for the treatment of inguinal hernia TAN Yong-hui. Department of Comprehensive Surgery， Jiangmen Xinhui District Luokeng Town Central Hospital， Jiangmen 529157， China

【Abstract】 Objective To observe the clinical efficacy and recurrence of open totally extraperitoneal prosthetic （TEP） for the treatment of inguinal hernia. Methods A total of 90 adult inguinal hernia patients as study subjects were divided by different surgical methods into research group and control group， with 45 cases in each group. The control group received traditional tension-free hernioplasty for treatment， and the research group received TEP for treatment. All patients were followed up for 1 year. The intraoperative indicators， postoperative short-term indicators and postoperative long-term indicators were compared between the two groups， and perioperative complications were recorded. Results The research group had better operation time as （15.46±

4.60） min， intraoperative bleeding volume as （4.45±1.33） ml， postoperative autonomic activity time as （14.32±1.65） h and hospitalization time as （4.32±0.35） d than （25.49±4.54） min， （8.36±1.75） ml， （25.72±

2.36） h and （6.75±0.40） d in the control group， and their difference was statistically significant （P<0.05）. The research group had lower incidence of complications as 6.67% than 26.67% in the control group， and lower 1-year recurrence rate as 0 than 8.89% in the control group. Their difference was statistically significant （P<0.05）. Conclusion Both open TEP and traditional tension-free hernioplasty have the characteristics of reliable and safe for adult inguinal hernia， but open TEP can shorten operation time， hospitalization time， reduce the incidence of complications， accelerate the postoperative recovery and reduce the long-term recurrence rate.