奚晓华　冯镇平　郑庆君

[摘要] 目的 对比腹腔镜腹股沟疝修补与开放性腹股沟疝修补的临床疗效与优缺点。 方法 选取2015年6月～2017年5月间我院肝胆外科腹股沟疝手术患者89例进行回顾行分析。根据治疗方法的不同分成对照组和研究组，其中开放性腹股沟疝修补组（对照组）58例，腹腔镜腹股沟疝修补组（研究组）31例。收集两组的手术时间、住院时间、术后复发、感染、慢性疼痛等并发症的发生情况、住院费用等临床资料并进行比较。 结果 研究组手术时间较对照组长，差异有统计学意义（P<0.05）；而研究组患者的住院费用比对照组的高，差异有统计学意义（P<0.05）。两组在术后复发率、术后感染，术后出现阴囊血肿等并发症情况比较有显著差异（P<0.05）。两组患者的临床治疗有效率比较有显著差异（P<0.05）。 结论 腹腔镜腹股沟疝手术治疗腹股沟疝患者，临床复发率低、并发症少、住院时间短，住院费用较高，但是治疗腹股沟疝的有效手段，值得推广。

[关键词] 腹腔镜；腹股沟疝；腹股沟疝修补术；疗效比较

[中图分类号] R656.21 [文献标识码] B [文章编号] 1673-9701（2017）36-0049-03

[Abstract] Objective To compare the clinical efficacy and advantages and disadvantages of laparoscopic inguinal hernia repair and open inguinal hernia repair. Methods 89 cases of inguinal hernia repairs which were conducted in the Department of Hepatobiliary Surgery in our hospital from June 2015 to May 2017 were selected and were retrospectively analyzed. According to the different treatment methods， the patients were divided into control group and study group. There were 58 cases in the open inguinal hernia repair group（control group）， and 31 cases in the laparoscopic inguinal hernia repair group（study group）. The clinical data such as operation time， length of stay， postoperative recurrence， infection， chronic pain and other complications， as well as cost of hospitalization were collected and compared between the two groups. Results The operation time in the study group was longer than that in the control group， and the difference was statistically significant（P<0.05）； the cost of hospitalization in the study group was higher than that in the control group， and the difference was statistically significant（P<0.05）. Postoperative recurrence rate， postoperative infection， postoperative complications such as scrotal hematoma were significantly different between the two groups（P<0.05）. There was significant difference in clinical efficiency between the two groups（P<0.05）. Conclusion Laparoscopic inguinal hernia surgical treatment of patients with inguinal hernia has a low clinical recurrence rate， fewer complications， shorter length of stay， and higher cost of hospitalization， but is the effective means of treatment of inguinal hernia， which is worthy of promotion.

[Key words] Laparoscopy；Inguinal hernia；Inguinal hernia repair；Comparison of efficacy

腹股沟疝是患者由于腹腔内胀气因为腹股沟出现缺损，而向体表突出造成的[1]。腹股沟疝包括：腹股沟直疝、腹股沟斜疝，一般腹股沟斜疝常在青壮年、儿童患者中发生，而腹股沟直疝一般发生在老年男性中，而且腹股沟直疝发病率明显高于腹股沟斜疝[2]。随着我国人口逐渐向老龄化发展，该症状发病率逐渐提高，临床对于腹股沟疝多是采取手术和保守治疗，保守治疗临床效果欠佳，仅能缓解临床症状，一旦患者出现嵌顿情况，很可能会给患者的生命造成威胁，同时错过最佳治疗时机，而手术治疗效果优于保守治疗。临床采取的手术治疗包括很多种，其中有開放式有张力疝修补手术、无张力疝修补术，还有腹腔镜微创手术治疗。本次研究中，主要针对开放式无张力腹股沟疝修补术与腹腔镜腹股沟疝修补术的临床效果分析，随机选择我院2015年6月～2017年5月肝胆外科89例接受腹股沟疝修补手术的患者进行分析，现报道如下。……