開放完全腹膜外腹股溝疝修補術治療腹股溝疝的臨床療效及復發情況分析

譚永輝

【摘要】 目的 觀察開放完全腹膜外腹股溝疝修補術（TEP）治療成人腹股溝疝的臨床療效及復發情況。方法 90例成人腹股溝疝患者作為研究對象， 按照手術方式將患者分為研究組和對照組， 各

45例。對照組給予傳統無張力疝修補術進行治療， 研究組給予TEP進行治療。術后隨訪1年， 比較兩組患者術中指標、術后近期指標及術后遠期指標， 記錄圍手術期并發癥發生情況。結果 研究組手術時間（15.46±4.60）min、術中出血量（4.45±1.33）ml、術后自主活動時間（14.32±1.65）h、住院時間（4.32±0.35）d

均優于對照組的（25.49±4.54）min、（8.36±1.75）ml、（25.72±2.36）h、（6.75±0.40）d， 差異有統計學意義（P<0.05）。研究組的并發癥發生率為6.67%低于對照組的26.67%， 研究組的1年復發率為0低于對照組的8.89%， 差異有統計學意義（P<0.05）。結論 開放TEP術和傳統無張力疝修補術治療成人腹股溝疝均具有療效可靠、安全性好的特點， 但開放TEP術能夠縮短手術時間及住院時間、降低并發癥發生率、加快術后康復、降低遠期復發率。

【關鍵詞】 腹股溝疝；開放完全腹膜外腹股溝疝修補術；無張力疝修補術；療效；復發

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.