| 聂 鑫,沙盈盈,宣 谅,胡勇杰,郑 晓,孙久运.腹腔镜下经腹腹膜前疝修补术与李金斯坦疝无张力修补术治疗老年腹股沟疝患者的疗效对比分析[J].,2022,(6):1069-1073 |
| 腹腔镜下经腹腹膜前疝修补术与李金斯坦疝无张力修补术治疗老年腹股沟疝患者的疗效对比分析 |
| Comparative Analysis of Curative Effect of Laparoscopic Transabdominal Preperitoneal Hernia Repair and Lichenstein's Tension-Free Hernia Repair in the Treatment of Elderly Patients with Inguinal Hernia |
| 投稿时间：2021-08-24 修订日期：2021-09-20 |
| DOI：10.13241/j.cnki.pmb.2022.06.015 |
| 中文关键词: 老年 腹股沟疝 TAPP Lichtenstein疝无张力修补术 疗效 |
| 英文关键词: Elderly Inguinal hernia TAPP Lichtenstein's tension-free hernia repair Curative effect |
| 基金项目:上海中医药大学附属岳阳中西医结合医院青年孵育项目（2018YJ09）；上海市卫生计生委科研课题青年项目（20174Y0082） |
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| 中文摘要: |
| 摘要 目的：对比腹腔镜下经腹腹膜前疝修补术（TAPP）和李金斯坦（Lichtenstein）疝无张力修补术两种手术方式治疗老年腹股沟疝患者的疗效。方法：收集2018年8月-2020年7月于上海中医药大学附属岳阳中西医结合医院甲疝外科治疗的118例老年(≥60岁)腹股沟疝患者的临床资料进行回顾性分析，根据不同的手术方法分组，68例患者行TAPP作为TAPP组，50例患者行Lichtenstein疝无张力修补术作为Lichtenstein组。比较两组患者手术时间、术中出血量、术后切口视觉模拟量表（VAS）评分、排气时间、住院时间及术后近远期并发症发生率。结果：两组患者手术时间比较无显著差异（P＞0.05）；TAPP组患者术中出血量、排气时间和住院时间均显著低于Lichtenstein组（P＜0.05）；TAPP组患者术后不同时点切口VAS评分均显著低于Lichtenstein组（P＜0.05）；TAPP组患者近期并发症发生率显著低于Lichtenstein组（P＜0.05）；两组患者远期并发症发生率比较无显著差异（P＞0.05）。结论：与Lichtenstein疝无张力修补术比较，TAPP是治疗老年腹股沟疝患者安全有效的手术方法，可减轻患者术后疼痛感，患者恢复更快，并发症发生率更低，值得推广及应用。 |
| 英文摘要: |
| ABSTRACT Objective: To compare the curative effect of laparoscopic transabdominal preperitoneal hernia repair (TAPP) and Lichtenstein's tension-free hernia repair of two types of surgery in the treatment of elderly patients with inguinal hernia. Methods: Clinical data of 118 elderly patients（≥60 years）with inguinal hernia in department of Thyroid and Hernia Surgery in Yueyang Hospital of integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine from August 2018 to July 2020 were retrospectively analyzed. According to different surgical methods, 68 patients received TAPP as the TAPP group, and 50 patients received Lichtenstein's tension-free hernia repair as the Lichtenstein group. The operative time, intraoperative blood loss, postoperative visual analog scale (VAS) score, exhaust time, hospital stay and postoperative short-term and long-term complication rate were compared between the two groups. Results: There was no significant difference in operation time between the two groups (P>0.05). The intraoperative blood loss, exhaust time and hospital stay in the TAPP group were significantly lower than those in the Lichtenstein group (P<0.05). The VAS scores of incision at different time points after operation in TAPP group were significantly lower than those in Lichtenstein group (P<0.05). The incidence of short-term complications in the TAPP group was significantly lower than that in the Lichtenstein group (P<0.05). There was no significant difference in the incidence of long-term complications between the two groups (P>0.05). Conclusion: Compared with Lichtenstein's tension-free hernia repair, TAPP is a safe and effective surgical method for the treatment of elderly patients with inguinal hernia, which can reduce postoperative pain, faster recovery and lower complication rate, and which is worthy of promotion and application. |
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