中华疝和腹壁外科杂志(电子版)
中華疝和腹壁外科雜誌(電子版)
중화산화복벽외과잡지(전자판)
CHINESE JOURNAL OF HERNIA AND ABDOMINAL WALL SURGERY(ELECTRONIC VERSION)
2015年
2期
101-104
,共4页
疝,腹股沟%疝修补术%腹部
疝,腹股溝%疝脩補術%腹部
산,복고구%산수보술%복부
Hernia,inguinal%Herniorrhaphy%Abdomen
目的:探讨经下腹正中切口腹膜前无张力疝修补术(后入路组)和完全腹膜外疝修补术(TEP 组)在成人腹股沟疝治疗中的临床效果。方法回顾性分析2012年1月至2013年12月,嘉应学院医学院附属医院85例腹股沟疝患者的临床资料,根据手术方式分为二组,后入路组43例, TEP 组42例。比较二组患者手术时间、住院时间、术后疼痛评分、住院费用、围手术期并发症(切口感染、阴囊血肿、尿潴留等)发生情况及复发情况。结果二组手术均顺利完成,TEP 组患者的住院时间、术后疼痛评分均低于后入路组,差异有统计学意义(t =3.070、6.006,P =0.007、0.000),而手术时间和住院费用高于后入路组,差异有统计学意义(t =6.730、7.890,P =0.003、0.000)。二组患者并发症发生率比较差异无统计学意义(χ2=0.079,P =0.778)。随访6~24个月,平均(19±4)个月,TEP 组分别于术后1年和15个月各复发1例,后入路组术后3个月复发1例,均再次手术后治愈。结论TEP 患者术后疼痛轻,下床活动早,住院时间短。经下腹部正中切口腹膜前无张力疝修补术费用低、技术易掌握,对双侧腹股沟疝、常规前进路的开放术后复发疝更为适合,值得基层医院推广。
目的:探討經下腹正中切口腹膜前無張力疝脩補術(後入路組)和完全腹膜外疝脩補術(TEP 組)在成人腹股溝疝治療中的臨床效果。方法迴顧性分析2012年1月至2013年12月,嘉應學院醫學院附屬醫院85例腹股溝疝患者的臨床資料,根據手術方式分為二組,後入路組43例, TEP 組42例。比較二組患者手術時間、住院時間、術後疼痛評分、住院費用、圍手術期併髮癥(切口感染、陰囊血腫、尿潴留等)髮生情況及複髮情況。結果二組手術均順利完成,TEP 組患者的住院時間、術後疼痛評分均低于後入路組,差異有統計學意義(t =3.070、6.006,P =0.007、0.000),而手術時間和住院費用高于後入路組,差異有統計學意義(t =6.730、7.890,P =0.003、0.000)。二組患者併髮癥髮生率比較差異無統計學意義(χ2=0.079,P =0.778)。隨訪6~24箇月,平均(19±4)箇月,TEP 組分彆于術後1年和15箇月各複髮1例,後入路組術後3箇月複髮1例,均再次手術後治愈。結論TEP 患者術後疼痛輕,下床活動早,住院時間短。經下腹部正中切口腹膜前無張力疝脩補術費用低、技術易掌握,對雙側腹股溝疝、常規前進路的開放術後複髮疝更為適閤,值得基層醫院推廣。
목적:탐토경하복정중절구복막전무장력산수보술(후입로조)화완전복막외산수보술(TEP 조)재성인복고구산치료중적림상효과。방법회고성분석2012년1월지2013년12월,가응학원의학원부속의원85례복고구산환자적림상자료,근거수술방식분위이조,후입로조43례, TEP 조42례。비교이조환자수술시간、주원시간、술후동통평분、주원비용、위수술기병발증(절구감염、음낭혈종、뇨저류등)발생정황급복발정황。결과이조수술균순리완성,TEP 조환자적주원시간、술후동통평분균저우후입로조,차이유통계학의의(t =3.070、6.006,P =0.007、0.000),이수술시간화주원비용고우후입로조,차이유통계학의의(t =6.730、7.890,P =0.003、0.000)。이조환자병발증발생솔비교차이무통계학의의(χ2=0.079,P =0.778)。수방6~24개월,평균(19±4)개월,TEP 조분별우술후1년화15개월각복발1례,후입로조술후3개월복발1례,균재차수술후치유。결론TEP 환자술후동통경,하상활동조,주원시간단。경하복부정중절구복막전무장력산수보술비용저、기술역장악,대쌍측복고구산、상규전진로적개방술후복발산경위괄합,치득기층의원추엄。
Objective To investigate the clinical outcome of the open preperitoneal tension-free hernia repair via lower abdominal median incision (posterior approach group)and totally extraperitoneal hernia repair (TEP group)in treatment of adult inguinal hernia.Methods The clinical data of 85 patients from January 201 2 to December 201 3 in Affiliated Hospital of Medicine College of Jiaying University were retrospectively analyzed,including 42 cases in TEP group and 43 cases in posterior group.The two groups were compared with operation time,hospitalization time,postoperative pain score,hospital cost and postoperative complications (wound infection,scrotal hematoma,urine retention,et al).Results Both procedures were successfully completed.The TEP group had significantly shorter length of stay and pain score than posterior approach group (t =3.070,6.006,P =0.007,0.000),but revealed more operation time and cost than the other group (t =6.730,7.890,P =0.003,0.000).There was no significant difference with regard to complications (χ2 =0.079,P =0.778).After a follow-up of 6 to 24 months (average 1 9 ±4 months),2 cases of recurrence in TEP group (at 1 years and 1 5 months after the operations,respectively)and one case in posterior approach group (at 3 month)occurred,and the re-operation were needed in these patients.Conclusion TEP has the advantages of less pain,early mobilization and short hospital stay.While,preperitoneal inguinal hernia repair via a lower abdominal median incision had a lower cost,and can be easy to master,especially suitable in patients with bilateral inguinal hernias or recurrent hernia after conventional anterior approach.It is worthy of promotion in primary hospitals.