兰义富 任继美 兰立春

【摘要】 目的：對比腹股沟疝患者应用经腹腔腹膜前腹腔镜疝修补术（TAPP）、疝环充填式无张力疝修补术的临床效果。方法：选取2018年1月-2019年12月于承德县医院接受治疗的60例腹股沟疝患者作为研究对象，采用随机数字表法将其分研究组与参照组，每组30例。研究组患者采用TAPP治疗，参照组患者采用疝环充填式无张力疝修补术治疗。对比两组临床指标、炎症因子水平、术后并发症发生情况。结果：两组手术时间对比，差异无统计学意义（P>0.05）;研究组术中出血量少于参照组，术后恢复正常活动时间、疼痛持续时间与住院时间均短于参照组，差异均有统计学意义（P<0.05）。术前，两组CRP、TNF-α、IL-6水平比较，差异均无统计学意义（P>0.05）;术后，两组CRP、TNF-α、IL-6水平均上升，但研究组升幅均小于参照组，差异均有统计学意义（P<0.05）。研究组并发症发生率为6.67%，虽低于参照组的13.33%，但差异无统计学意义（P>0.05）。结论：在腹股沟疝患者治疗中实施TAPP，可减少术中出血量、缩短术后恢复正常活动时间、疼痛持续时间及住院时间，患者术后应激反应较轻，可有效降低并发症发生率。

【关键词】 腹股沟疝 腹腔镜疝修补术 疝环充填式无张力疝修补术 炎症因子

Comparison of the Clinical Effect of Laparoscopic Herniorrhaphy and Mesh Plug Tension-free Herniorrhaphy in the Treatment of Inguinal Hernia/LAN Yifu， REN Jimei， LAN Lichun. //Medical Innovation of China， 2021， 18（29）： -169

[Abstract] Objective： To compare the clinical effect of TAPP and mesh plug tension-free herniorrhaphy. Method： A total of 60 patients with inguinal hernia who were treated in the Chengde County Hospital from January 2018 to December 2019 were selected as the study objects. They were divided into study group and reference group by random number table method， 30 cases in each group. Patients in the study group were treated with TAPP， and patients in the reference group were treated with hernia ring filling tension-free hernia repair. Clinical indicators， inflammatory factors and postoperative complications were compared between the two groups. Clinical indicators， inflammatory factors and postoperative complications were compared between the two groups. Result： There was no significant difference in operation time between the two groups （P>0.05）; the amount of intraoperative blood loss in the study group was less than that in the reference group， and the postoperative recovery time， pain duration and hospital stay were shorter than those in the reference group， the differences were statistically significant （P<0.05）. Before surgery， there were no significant differences in the levels of CRP， TNF-α， IL-6 between the two groups （P>0.05）; after operation， the levels of CRP， TNF-α and IL-6 in both groups increased， but the increase in the study group were less than those in the reference group， the differences were statistically significant （P<0.05）. The complication rate in the study group was 6.67%， which was lower than 13.33% in the reference group， but the difference was not statistically significant （P>0.05）. Conclusion： TAPP in the treatment of patients with inguinal hernia can reduce the amount of bleeding during the operation， shorten the time of recovery of normal activities， the duration of pain and the length of hospitalization. The postoperative stress response of patients is less， and effectively reduce the incidence of complications.

[Key words] Inguinal hernia Laparoscopic hernia repair Mesh plug tension-free hernia repair Inflammatory factors

First-author’s address： Chengde County Hospital， Chengde 067400， China

doi：10.3969/j.issn.1674-4985.2021.29.041

腹股溝疝为普外科常见疾病之一，是指腹腔内脏器通过腹股沟区的缺损向体表突出所形成的包块，患者在活动或站立时包块会自行突出，甚至会掉入阴囊内，对患者日常生活产生严重影响[1]。目前，疝环充填式无张力疝修补术与TAPP均是腹股沟疝患者的常用治疗术式，两种术式各具优点，前者具有无张力、操作简单等特点，可降低复发率;后者则是可借助腹腔镜进行手术，有效减轻对患者机体的损伤[2]。……