郭愛平
【摘要】目的:評(píng)估腹股溝疝患者實(shí)施腹腔鏡腹膜前腹股溝疝修補(bǔ)術(shù)及傳統(tǒng)手術(shù)治療的并發(fā)癥率。方法:對(duì)50例本醫(yī)院實(shí)施治療的腹股溝疝予以項(xiàng)目研究,信息采集時(shí)間為2020年1月—2021年1月,以隨機(jī)數(shù)字表法為分組方案,對(duì)照組(n=25,傳統(tǒng)手術(shù)治療)和觀察組(n=25,腹腔鏡腹膜前腹股溝疝修補(bǔ)術(shù)治療),統(tǒng)計(jì)及對(duì)比組間臨床指標(biāo)及術(shù)后并發(fā)癥情況。結(jié)果:(1)對(duì)比對(duì)照組患者,觀察組的腹股溝疝患者出血量較低,觀察組下床時(shí)間、排氣時(shí)間、住院時(shí)長(zhǎng)統(tǒng)計(jì)指標(biāo)較短,具備組間統(tǒng)計(jì)學(xué)差異性(P<0.05)。(2)對(duì)比對(duì)照組患者,觀察組的腹股溝疝患者術(shù)后切口疼痛、尿潴留、陰囊水腫、發(fā)熱等并發(fā)癥發(fā)生率統(tǒng)計(jì)指標(biāo)較低,具備組間統(tǒng)計(jì)學(xué)差異性(P<0.05)。結(jié)論:腹腔鏡腹膜前腹股溝疝修補(bǔ)術(shù)對(duì)于患者的創(chuàng)傷相對(duì)較小,能夠縮短患者術(shù)后恢復(fù)時(shí)間,其并發(fā)癥發(fā)生率相對(duì)較低。
【關(guān)鍵詞】腹股溝疝;腹腔鏡腹膜前腹股溝疝修補(bǔ)術(shù);傳統(tǒng)手術(shù);并發(fā)癥
Comparison of complication rate between laparoscopic preperitoneal inguinal hernia repair and traditional surgery
GUO Aiping
Xinhe Hospital,Datong City, Shanxi, Datong, Shanxi 037006, China
【Abstract】Objective:To evaluate the complication rate of laparoscopic preperitoneal inguinal hernia repair and traditional surgery treatment in patients with inguinal hernia.Methods:50 cases of inguinal hernia treated in the hospital were studied,the information collected from January 2020 to January 2021.Taking the random number table method as the grouping scheme,including the control group(n=25,traditional surgical treatment)and the observation group(n=25,Laparoscopic preperitoneal inguinal hernia repair),and the clinical indicators and postoperative complications between the two groups were counted and compared.Results:(1)Compared with the control group,the amount of bleeding in patients with inguinal hernia in the observation group was lower,and the statistical indexes of getting out of bed time, exhaust time and length of hospitalization in the observation group were shorter,with statistical difference between the two groups(P<0.05).(2)The incidence of postoperative pain,urinary retention,scrotal edema and fever were lower in the observation group than those in the control group,with statistical differences between the two groups(P<0.05). Conclusion:Laparoscopic preperitoneal inguinal hernia repair has relatively small trauma to shorten the postoperative recovery time,and the complication rate is low.
【Key Words】Inguinal hernia; Laparoscopic preperitoneal inguinal hernia repair; traditional surgery; Complications
腹股溝疝是臨床常見疾病之一,由于腹股溝位置是腹腔薄弱點(diǎn),故發(fā)生疝氣的可能性相對(duì)較高,臨床治療腹股溝疝一般多采用手術(shù)形式,但手術(shù)后發(fā)生并發(fā)癥的可能性相對(duì)較高[1]。對(duì)此,本研究針對(duì)腹股溝疝治療方案進(jìn)行分析,討論腹腔鏡腹膜前腹股溝疝修補(bǔ)術(shù)及傳統(tǒng)手術(shù)治療的應(yīng)用價(jià)值。
1.1 臨床資料
對(duì)2020年1月—2021年1月本醫(yī)院實(shí)施治療的腹股溝疝予以項(xiàng)目研究,信息采集數(shù)量為50例,通過(guò)隨機(jī)數(shù)字表法用以分組,分別選取為觀察組與對(duì)照組,每組均納入25例。觀察組,男性18例,女性7例,年齡30~86歲,平均年齡(58.27±11.04)歲;對(duì)照組,男性16例,女性9例,年齡30~87歲,平均年齡(58.31±11.08)歲。對(duì)比兩組腹股溝疝患者年齡、性別數(shù)據(jù)資料(P>0.05)證實(shí)兩組可予以對(duì)比論證。
1.2 方法
對(duì)照組通過(guò)傳統(tǒng)手術(shù)治療,取患者仰臥位,予以硬膜外麻醉,在患者腹股溝韌帶上側(cè)20mm位置作一切口,逐層切開后充分暴露患者疝囊,游離其疝囊后放置聚丙烯補(bǔ)片,重塑其內(nèi)環(huán)口并能夠在腹股溝后壁進(jìn)行修補(bǔ),固定補(bǔ)片后實(shí)施逐層縫合[2-4]。觀察組選擇腹腔鏡腹膜前腹股溝疝修補(bǔ)術(shù)治療,取患者頭低腳高仰臥位,予以全身麻醉,在其臍部下緣作一切口,置入腹腔鏡,實(shí)施二氧化碳?xì)飧共僮鱗5]。分別與臍左側(cè)與右側(cè)做切口,分離暴露疝囊,游離腹膜前間隙,與操作孔納入補(bǔ)片,與腹膜前置補(bǔ)片,固定后,縫合腹膜[6]。8BB2951C-72B2-43B8-BECB-C304EA00CFF2
1.3 統(tǒng)計(jì)學(xué)分析
采用SPSS 21.0統(tǒng)計(jì)學(xué)軟件進(jìn)行數(shù)據(jù)分析。計(jì)數(shù)資料采用(%)表示,進(jìn)行χ2檢驗(yàn),計(jì)量資料采用(χ±s)表示,進(jìn)行t檢驗(yàn),P<0.05為差異具有統(tǒng)計(jì)學(xué)意義。
2.1 兩組腹股溝疝患者出血量、下床時(shí)間、排氣時(shí)間、住院時(shí)長(zhǎng)指標(biāo)比較
對(duì)比對(duì)照組,觀察組的腹股溝疝患者出血量較低,觀察組下床時(shí)間、排氣時(shí)間、住院時(shí)長(zhǎng)統(tǒng)計(jì)指標(biāo)較短,具備組間統(tǒng)計(jì)學(xué)差異性(P<0.05),見表1。
2.2 兩組腹股溝疝患者術(shù)后切口疼痛、尿潴留、陰囊水腫、發(fā)熱等并發(fā)癥情況比較
對(duì)比對(duì)照組患者,觀察組的腹股溝疝患者術(shù)后切口疼痛、尿潴留、陰囊水腫、發(fā)熱等并發(fā)癥發(fā)生率統(tǒng)計(jì)指標(biāo)較低,具備組間統(tǒng)計(jì)學(xué)差異性(P<0.05),見表2。
腹股溝疝是臨床中常見疾病,是男性群體高發(fā)疾病,一般多為腹腔壓力升高、腹壁肌力下降所致,其主要癥狀表現(xiàn)為腹股溝包塊、疼痛等,通過(guò)手術(shù)方式可予以治療[7]。對(duì)此,本研究針對(duì)腹股溝疝患者實(shí)施腹腔鏡腹膜前腹股溝疝修補(bǔ)術(shù)及傳統(tǒng)手術(shù)治療,結(jié)果顯示,對(duì)比對(duì)照組,觀察組的腹股溝疝患者出血量較低,觀察組下床時(shí)間、排氣時(shí)間、住院時(shí)長(zhǎng)統(tǒng)計(jì)指標(biāo)較短,觀察組的腹股溝疝患者術(shù)后切口疼痛、尿潴留、陰囊水腫、發(fā)熱等并發(fā)癥發(fā)生率統(tǒng)計(jì)指標(biāo)較低。腹腔鏡腹膜前腹股溝疝修補(bǔ)術(shù)效果確切,該術(shù)式通過(guò)微創(chuàng)手術(shù)形式,能夠減小手術(shù)對(duì)于患者的創(chuàng)傷,患者術(shù)后炎性因子水平得以控制,尤其可保護(hù)患者腹股溝位置,手術(shù)安全性水平顯著高于傳統(tǒng)手術(shù)形式[8]。
綜合以上結(jié)果,腹腔鏡腹膜前腹股溝疝修補(bǔ)術(shù)于腹股溝疝治療中具備臨床推廣應(yīng)用的價(jià)值。
參考文獻(xiàn)
[1] 黃翠景,吳永豐,劉興洲.無(wú)張力疝修補(bǔ)術(shù)與腹腔鏡全腹膜外疝修補(bǔ)術(shù)治療老年腹股溝疝的臨床效果及安全性評(píng)價(jià)[J].中國(guó)醫(yī)刊,2021,56(4):439-442.
[2] 吳浩瀚,吳文涌,張順,等.腹腔鏡下不同術(shù)式和開放手術(shù)疝修補(bǔ)術(shù)對(duì)腹股溝疝治療效果的前瞻性隨機(jī)對(duì)照研究[J].中華疝和腹壁外科雜志(電子版),2021,15(1):35-39.
[3] 王劉曼,劉星,付波.基于循證的圍術(shù)期管理在腹腔鏡全腹膜外腹股溝疝修補(bǔ)術(shù)中的應(yīng)用[J].中國(guó)現(xiàn)代普通外科進(jìn)展,2021,24(8):617-620,625.
[4] 張昕,顧遠(yuǎn)輝,李小飛,等.腹腔鏡TAPP術(shù)和“兩針”連續(xù)腹膜縫合技術(shù)在腹股溝疝修補(bǔ)術(shù)中的應(yīng)用[J].中國(guó)現(xiàn)代普通外科進(jìn)展,2021,24(5):357-359,363.
[5] 張菲菲,李殷南.腹腔鏡經(jīng)腹腹膜前疝修補(bǔ)術(shù)治療同側(cè)復(fù)發(fā)性腹股溝疝的可行性分析[J].中華疝和腹壁外科雜志(電子版),2021,15(1):31-34.
[6] 李炳根,龔獨(dú)輝,賴澤如,等.腹腔鏡腹股溝斜疝無(wú)張力修補(bǔ)術(shù)中疝環(huán)關(guān)閉技術(shù)的應(yīng)用[J].中華疝和腹壁外科雜志(電子版),2021,15(3):219-222.
[7] 李芳,王峻峰.腹腔鏡經(jīng)腹腹膜前疝修補(bǔ)術(shù)治療腹股溝復(fù)發(fā)疝的臨床療效及安全性[J].中華疝和腹壁外科雜志(電子版),2021,15(4):421-429.
[8] 張美英.腹腔鏡經(jīng)腹腹膜前疝修補(bǔ)術(shù)對(duì)腹股溝疝患者術(shù)后恢復(fù)、凝血功能及男性性功能的影響[J].中華疝和腹壁外科雜志(電子版),2021,15(3):228-232.8BB2951C-72B2-43B8-BECB-C304EA00CFF2