發(fā)布時間：2018-10-10 06:08

【摘要】：目的:本研究通過觀察腹腔鏡下經(jīng)腹膜前疝修補術(shù)(laparoscoplc trans-abdominal preperitoneal hernia repair,TAPP)治療腹股溝嵌頓疝的臨床效果,為臨床治療腹股溝區(qū)嵌頓疝提供參考手術(shù)方式。方法:選取青海大學附屬醫(yī)院腹部腔鏡外科2012年11月至2014年10月腹股溝嵌頓疝患者65例,A組:20例(行腹股溝嵌頓疝腹腔鏡下復(fù)位+TAPP);B組:21例(行腹股溝嵌頓疝切開復(fù)位+腹股溝疝修補術(shù),OR);C組:24例(行腹股溝嵌頓疝切開復(fù)位+疝囊高位結(jié)扎,high ligation of hernia sac,HL)。評價指標:三組手術(shù)時間、住院時間、術(shù)中出血量、術(shù)后疼痛發(fā)生率、術(shù)后胃腸功能恢復(fù)時間、以及并發(fā)癥相關(guān)指標比較。結(jié)果:所有患者經(jīng)治療后,均治愈出院。(1)A組手術(shù)時間較B組、C組手術(shù)時間長(P0.05);(2)A組住院時間、術(shù)中出血量、術(shù)后下床活動時間、術(shù)后胃腸功能恢復(fù)時間及止痛藥物使用例數(shù),與B、C組進行比較,差異均有統(tǒng)計學意義(P0.05);(3)三組術(shù)后皮下血腫、腹腔感染、陰囊腫脹及切口感染指標比較,差異無統(tǒng)計學意義(P0.05);(4)A組術(shù)后復(fù)發(fā)率低于B、C組,差異有統(tǒng)計學意義(P0.05);B組復(fù)發(fā)率同樣低于C組,差異有統(tǒng)計學意義(P0.05)。結(jié)論:腹腔鏡下經(jīng)腹膜前疝無張力修補術(shù)(TAPP)術(shù)中可以充分探查腹腔,避免了遺漏壞死的腸管風險,其具有創(chuàng)傷小、術(shù)后恢復(fù)快、住院時間短及術(shù)后復(fù)發(fā)率低等優(yōu)勢,因此認為,其是治療腹股溝嵌頓疝的一種安全、有效的術(shù)式,臨床上可根據(jù)患者的實際情況適時應(yīng)用。
[Abstract]:Objective: to observe the clinical effect of laparoscopic anterior peritoneal hernioplasty (laparoscoplc trans-abdominal preperitoneal hernia repair,TAPP) in the treatment of incarcerated inguinal hernia, and to provide a reference for clinical treatment of incarcerated inguinal hernia. Methods: from November 2012 to October 2014, 65 patients with incarcerated inguinal hernia in the affiliated Hospital of Qinghai University were selected from 65 patients with inguinal incarcerated hernia. Group A: 20 cases (performed laparoscopic reduction of inguinal incarcerated hernia TAPP) group B: 21 cases (performed inguinal incarcerated hernia resection) Open reduction inguinal hernioplasty (OR) Group C (24 cases with inguinal incarcerated hernia) were treated with open reduction of high ligation of hernia sac and high ligation of hernia sac,HL. Evaluation measures: operative time, hospitalization time, intraoperative bleeding volume, postoperative pain incidence, postoperative gastrointestinal function recovery time, and complications were compared among the three groups. Results: all the patients were cured and discharged after treatment. (1) the operation time of group A was longer than that of group B (P0.05); (2), the amount of bleeding during operation, the time of getting out of bed after operation, the time of recovery of gastrointestinal function after operation and the number of cases using analgesic drugs. Compared with group C, the difference was statistically significant (P0.05); (3). The postoperative subcutaneous hematoma, celiac infection, scrotal swelling and wound infection were not significantly different in group A (P0.05); (4), the recurrence rate of group A was lower than that of group B (P0.05). The recurrence rate of group B was also lower than that of group C (P0.05). Conclusion: laparoscopic transurethral tension-free repair of preperitoneal hernia (TAPP) can fully explore the abdominal cavity and avoid the risk of missing necrotic bowel. It has the advantages of small trauma, quick postoperative recovery, short hospital stay and low recurrence rate. It is a safe and effective method for the treatment of inguinal incarcerated hernia.
【學位授予單位】：青海大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R656.2

【參考文獻】

相關(guān)期刊論文 前9條

1 杜漢朋;何永忠;孔凡東;;經(jīng)腹腔腹膜前疝修補術(shù)治療腹股溝嵌頓疝的治療體會[J];中華疝和腹壁外科雜志(電子版);2014年03期

2 陳雙;唐健雄;馬頌章;;成人腹股溝疝診療指南[J];中國實用外科雜志;2012年10期

3 李業(yè)華;張思宇;蘇國強;;應(yīng)用腹腔鏡技術(shù)診治復(fù)發(fā)性腹股溝疝[J];中華疝和腹壁外科雜志(電子版);2009年02期

4 江浩;丁銳;姚琪遠;陳浩;花榮;譚德炎;;腹股溝區(qū)腹膜前解剖和疝修補術(shù)[J];中國臨床解剖學雜志;2008年02期

5 王秋生;唐本強;;腹腔鏡在急腹癥中的應(yīng)用[J];臨床外科雜志;2008年03期

6 白立芳;劉國慶;唐華建;王劍鋒;李煥;李杰榮;;小兒腹股溝嵌頓疝的腹腔鏡手術(shù)[J];臨床小兒外科雜志;2006年02期

7 ;腹腔鏡腹股溝疝修補術(shù)常規(guī)[J];腹腔鏡外科雜志;2006年02期

8 王存川,張松柏,陳捚,胡友主;腹腔鏡疝修補手術(shù)222例經(jīng)驗[J];中國普外基礎(chǔ)與臨床雜志;2005年06期

9 李健文,鄭民華,董峰,王明亮,陸愛國,胡偉國,毛志海,臧潞,蔣渝;腹腔鏡腹股溝疝修補術(shù)的經(jīng)驗總結(jié)(附235例報告)[J];外科理論與實踐;2005年02期

，

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