陈剑明 陈国平 涂锴

[摘要] 目的 分析腹腔镜完全腹膜外疝修补术（TEP）与传统疝修补术治疗腹股沟疝的临床疗效。 方法 选择我院2014年1月～2017年8月期间收治的94例腹股沟疝患者随机分为两组，对照组45例接受传统疝修补术治疗，研究组49例接受腹腔镜完全腹膜外疝修补术治疗，观察两组的临床治疗效果。 结果 研究组并发症总发生率4.08%低于对照组17.78%（P<0.05）。研究组住院费用高于对照组，住院时间、术后疼痛时间、手术时间低于对照组（P<0.05）。研究组复发率0%低于对照组6.67%（P<0.05）。两组患者SDS、SAS评分比较，治疗前差异无统计学意义（P>0.05），治疗后，研究组评分低于对照组（P<0.05）。 结论 临床治疗腹股沟疝建议采用TEP手术，虽此方式和传统疝修补术比較，其治疗费用较高，但可降低并发症发生率，疾病恢复速度快，具有较大应用价值。

[关键词] 传统疝修补术；腹腔镜完全腹膜外疝修补术；腹股沟疝；并发症

[中图分类号] R656.2 [文献标识码] B [文章编号] 1673-9701（2018）15-0051-03

Comparison of clinical efficacy of laparoscopic totally extraperitoneal hernia repair （TEP） and traditional hernia repair in inguinal hernia

CHEN Jianming CHEN Guoping TU Kai

Department of General Surgery， Fuzhou Second Hospital in Fujian Province， Fuzhou 350000， China

[Abstract] Objective To analyze the clinical efficacy of laparoscopic totally extraperitoneal hernia repair（TEP） and traditional hernia repair in the treatment of inguinal hernia. Methods 94 inguinal hernia patients admitted in our hospital from January 2014 to August 2017 were randomly divided into two groups. 45 patients in the control group received conventional hernia repair and 49 patients in the study group received laparoscopic totally extraperitoneal hernia repair. The clinical treatment effects between the two groups were compared. Results The overall incidence of complications in the study group was 4.08% ， which was lower than 17.78% in the control group（P<0.05）. The hospitalization cost of the study group was higher than that of the control group. The hospitalization time， postoperative pain time and operation time in the study group was lower than that in the control group（P<0.05）. The recurrence rate（0%） in the study group was lower than 6.67% in the control group（P<0.05）. There was no significant difference in SDS and SAS scores between the two groups before treatment（P>0.05）. After treatment， the scores in the study group were lower than those in the control group（P<0.05）. Conclusion It is recommended to use TEP for clinical treatment of inguinal hernia. Although this method is more expensive than conventional hernia repair， it can reduce the incidence of complications and make the disease recover quickly. It has great application value.

[Key words] Traditional hernia repair； Laparoscopic totally extraperitoneal hernia repair； Inguinal hernia； Complication

腹股沟疝为临床普外科常见疾病之一，首选治疗方式为疝修补术[1]。但传统疝修补术存在多种缺陷，如术后不适症状、复发率高等。因医学界对腹股沟生理解剖的研讨逐步深入，加之修补材料的改进，无张力疝修补术已发展为主流方式，包含Kugel术式、Rutkow术式等[2]。TEP手术指在腹膜前间隙部位实施修补，此为腹腔镜腹股沟疝修补术的金标准手术。近几年来，因微创技术快速发展，腹腔镜手术日渐成熟，TEP手术在腹股沟疝中得到广泛应用。为此，本研究纳入94例患者分两组讨论TEP治疗效果。现报道如下。

1 资料与方法

1.1 一般资料

选择我院2014年1月～2017年8月期间收治的94例腹股沟疝患者。随机分为对照组45例：男30例，女15例，年龄25～77岁，平均（55.4±8.2）岁，29例直疝，16例腹股沟斜疝；研究组49例：男35例，女14例，年龄25～76岁，平均（55.6±8.1）岁，29例直疝，20例腹股沟斜疝。两组患者基本资料比较差异无统计学意义（P>0.05）。

入选标准：①患者均满足2014版《成人腹股沟疝诊疗指南》中腹股沟疝判定标准[3]；……