腹腔镜微创技术进行疝修补术的临床效果研究
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摘要
目的:探讨腹腔镜微创技术在疝修补手术中的应用效果。方法:以2014年3月~2016年3月在我院与东南大学附属中大医院接受治疗的80例腹股沟疝患者为观察对象。根据其治疗方式分为腹腔镜微创组(42例)和开放式疝修补术组(38例)。观察两组患者手术一般情况,比较两组患者术后疼痛及术后并发症发生率的差异。结果:腹腔镜微创组患者手术时间为42.17±5.93min,下床活动时间为19.92±4.31h,住院天数为5.87±1.05d,均较开放式疝修补术组短,而术中出血量为12.98±5.02ml,明显较开放式疝修补术组少,差异具有统计学意义;两组患者术后疼痛得分(VAS)存在显著差异:腹腔镜微创组患者术后第1天、第3天、第5天和第7天的VAS得分均低于开放组,差异具有统计学意义;腹腔镜微创组患者局部血肿、切口感染的发生率和复发率明显低于开放式疝修补术组患者,两组患者切口裂开和尿潴留发生率无明显差别。结论:腹腔镜微创技术在疝修补手术中的应用,可明显缩短手术时间,减少术中出血量,且术后复发率低,具有较高的临床应用价值。
Objective To explore the application effect of laparoscopic minimally invasive technique in hernia repair. Methods 80 cases of inguinal hernia treated in our hospital from March 2014 to March 2016 were observed. According to the way of treatment, which were divided into two groups: laparoscopic minimally invasive group(42 cases) and open mesh repair group(38 cases). The general surgery, compared the two groups of patients with postoperative pain and postoperative complications of the two groups. Results Laparoscopic group of patients at the time of surgery was 42.17±5.93 min, ambulation time was 19.92±4.31 h, length of hospital stay was 5.87±1.05 d, were more open hernia repair group short, and intraoperative blood loss was 12.98±5.02 ml, obvious open hernia repair group less, the difference with unified significance. The postoperative pain score(VAS) of the two groups had significant differences: the 1 day, 3 days, the 5 days after laparoscopic radical resection for patients in the minimally invasive group and 7 days of VAS scores were lower than those in the open group, the difference is statistically significant; The incidence of local hematoma, incision infection and recurrence rate were significantly lower in the laparoscopic minimally invasive group than in the open type hernia repair group, and there was no significant difference between the two groups in the groups. Conclusion Laparoscopic hernia repair technique in surgery, can significantly shorten the operation time, reduce the amount of bleeding, and the recurrence rate is low, it has high value in clinical application.
Objective To explore the application effect of laparoscopic minimally invasive technique in hernia repair. Methods 80 cases of inguinal hernia treated in our hospital from March 2014 to March 2016 were observed. According to the way of treatment, which were divided into two groups: laparoscopic minimally invasive group(42 cases) and open mesh repair group(38 cases). The general surgery, compared the two groups of patients with postoperative pain and postoperative complications of the two groups. Results Laparoscopic group of patients at the time of surgery was 42.17±5.93 min, ambulation time was 19.92±4.31 h, length of hospital stay was 5.87±1.05 d, were more open hernia repair group short, and intraoperative blood loss was 12.98±5.02 ml, obvious open hernia repair group less, the difference with unified significance. The postoperative pain score(VAS) of the two groups had significant differences: the 1 day, 3 days, the 5 days after laparoscopic radical resection for patients in the minimally invasive group and 7 days of VAS scores were lower than those in the open group, the difference is statistically significant; The incidence of local hematoma, incision infection and recurrence rate were significantly lower in the laparoscopic minimally invasive group than in the open type hernia repair group, and there was no significant difference between the two groups in the groups. Conclusion Laparoscopic hernia repair technique in surgery, can significantly shorten the operation time, reduce the amount of bleeding, and the recurrence rate is low, it has high value in clinical application.
引文
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[13]李文标,湛海伦,周祥福,等.腹腔镜下腹股沟疝修补术后网片侵蚀膀胱临床分析[J].中华腔镜泌尿外科杂志:电子版,2014,8(1):31-34.
[14]阿不来提,肖国权.基层医院腹腔镜食管裂孔疝修补术的应用探讨[J].中华胃食管反流病电子杂志,2015,2(1):59-59.
[15]辛维栋,魏煜程,陈立材.腹腔镜手术治疗食管裂孔疝28例临床疗效分析[J].中华疝和腹壁外科杂志:电子版,2015,9(5):17-18.
[2]克力木,阿力木江·麦斯依提,伊比提哈尔,等.腹腔镜膈疝修补术的临床疗效[J].中华消化外科杂志,2015,14(10):832-834.
[3]辜树勇,沈映玲,郑宗珩.腹腔镜完全腹膜外疝修补术中聚丙烯3D补片应用的价值分析[J].中华疝和腹壁外科杂志:电子版,2015,9(4):40-43.
[4]王勇,段鑫,罗文,等.腹腔镜食管裂孔疝修补术12例体会及操作要点分析[J].中华胃食管反流病电子杂志,2015,2(1):25-27.
[5]邓锐,褚亮,杨功安.腹腔镜疝修补术与传统疝修补术治疗160例腹股沟疝患者的疗效比较[J].中华全科医学,2015,13(11):1784-1786.
[6]李文君,夏鑫,孙喜太,等.腹腔镜腹股沟疝修补术后血清肿的治疗[J].中华腔镜外科杂志(电子版),2014,7(6):36-38.
[7]魏海梁.腹腔镜下疝修补术在腹股沟疝中的临床应用价值[J].中华疝和腹壁外科杂志(电子版),2015,9(5):11-13.
[8]Huang B S,Lee F K,Wang P H.Trocar site hernia after laparoscopy,including robotic-assisted laparoscopy[J].Journal of the Chinese Medical Association Jcma,2014,77(2):59-60.
[9]Mishra A,Keeler B D,Maxwell-Armstrong C,et al.The influence of laparoscopy on incisional hernia rates:a retrospective analysis of1057 colorectal cancer resections[J].Colorectal Disease,2014,16(10):815-21.
[10]Kirby G C,Dawson R.Transhernial laparoscopy in strangulated groin and ventral hernias[J].Annals of the Royal College of Surgeons of England,2016,98(1):69-70.
[11]Rebibo L,Dhahri A,Chivot C,et al.Trocar site hernia after laparoscopic sleeve gastrectomy using a specific open laparoscopy technique[J].Surgery for Obesity&Related Diseases,2014,11(4):791-796.
[12]魏海梁.腹腔镜下疝修补术在腹股沟疝中的临床应用价值[J].中华疝和腹壁外科杂志(电子版)2015,9(5):11-13.
[13]李文标,湛海伦,周祥福,等.腹腔镜下腹股沟疝修补术后网片侵蚀膀胱临床分析[J].中华腔镜泌尿外科杂志:电子版,2014,8(1):31-34.
[14]阿不来提,肖国权.基层医院腹腔镜食管裂孔疝修补术的应用探讨[J].中华胃食管反流病电子杂志,2015,2(1):59-59.
[15]辛维栋,魏煜程,陈立材.腹腔镜手术治疗食管裂孔疝28例临床疗效分析[J].中华疝和腹壁外科杂志:电子版,2015,9(5):17-18.