三种不同方案修补术治疗腹股沟疝的临床疗效及安全性分析

摘要

目的 探讨疝环充填式无张力疝修补术、全腹膜外补片植入术(TEP)、经腹腹膜前补片植入术(TAPP)治疗腹股沟疝的临床疗效及安全性.方法 选取我院收治的167例腹股沟疝患者,按照随机数字表法将患者随机分为A组(疝环充填式无张力疝修补术治疗组)55例、B组(TEP治疗组)56例和C组(TAPP治疗组)56例,比较三组疗效.结果 3组手术时间[(55.25±8.23) min vs.(54.35±8.19)min vs.(53.59±8.36)min]、术后首次下床活动时间[(30.33±4.16)h vs.(32.18±3.98)h vs.(31.22±3.77)h]、住院时间[(5.66±1.38)d vs.(5.58±1.41)d vs.(5.77±1.57)d)]、早期并发症发生率(3.64％ vs.3.57％ vs.3.57％)、术后ld的疼痛情况[(4.11±1.51) vs.(4.13±1.62)vs.(4.22±1.49)]差异均无统计学意义(P＞0.05);术后1个月[(2.35±1.19) vs.(2.37±1.21) vs.(3.27±1.24)]及术后6个月[(1.57±0.97)vs.(1.56±0.92)vs.(2.21±1.01)]B组及C组疼痛情况均优于A组(P＜0.05).结论 疝环充填式无张力疝修补术、TEP、TAPP均是治疗腹股沟疝安全、有效、可行的术式,各有其优缺点,临床上应根据患者个体情况选择合适的术式治疗.%Objective To explore the clinical efficacy and safety of hernia ring filling type without tension hernia repair,full of extraperitoneal patch implantation (TEP),and abdominal peritoneal patch before implantation (TAPP) for inguinal hernia.Methods 167 patients with inguinal hernia treated at our hospital were selected and were divided into group A (n=55),treated with hernia ring filling type without tension hernia repair,group B (n=56),treated with TEP,and group C (n=56),treated with TAPP,according to random number table method.The efficacies were compared between these three groups.Results There were no statistical differences in operation time[(55.25±8.23) min vs.(54.35±8.19) min vs.(53.59±8.36) min],time for first off-bed activity after the operation [(30.33±4.16) h vs.(32.18±3.98) h vs.(31.22±3.77) h],hospitalization time [(5.66±1.38) d vs.(5.58±1.41) d vs.(5.77±1.57) d],the incidence of early complications (3.64％ vs.3.57％ vs.3.57％),pain 1 day after the operation [(4.11±1.51) vs.(4.13±1.62) vs.(4.22±1.49)] between these three groups (P＜0.05).1 month [(2.35±1.19) vs.(2.37±1.21) vs.(3.27±1.24)] and 6 months [(1.57±0.97) vs.(1.56±0.92) vs.(2.21±1.01)] after the operation,the pain were better in group B and group C than in group A (P＜0.05).Conclusions Hernia ring filling type without tension hernia repair,TEP,and TAPP for inguinal hernia are safe,effective,and feasible and have their own advantages and disadvantages.The patients should be individualizedly treated with a optimal surgical method.