腹腔镜疝修补术与开放无张力修补术治疗腹股沟疝的疗效

目的探讨腹腔镜疝修补术与无张力修补术治疗腹股沟疝的效果比较。 方法选取2018年1月至2020年12月于恩施土家族苗族自治州中心医院就诊的腹股沟疝患者320例，以随机数字表分为腔镜组和开放组，每组患者160例。腔镜组行腹腔镜下疝修补术治疗，开放组以无张力修补术进行治疗。对比2组患者的手术出血量、手术时间、切口长度、切口美观评分、住院时间、下床活动时间、第一次排气时间、住院费用、术后并发症情况及治疗效果。 结果与开放组比较，腔镜组患者手术出血量少、手术时间短及切口长度短（P<0.05），切口美观评分明显高于开放组（P<0.05），住院时间、下床活动时间、第一次排气时间均明显短于开放组，但在住院费用方面明显高于开放组（P<0.05）。治疗后2组患者的复发率、治愈率比较，差异无统计学意义（P>0.05）；腔镜组患者的总并发症发生率（5.00%）明显低于开放组（19.38%），差异有统计学意义（P<0.05）。 结论相较于开放式无张力修补术，腹腔镜疝修补术治疗腹股沟疝能减少手术中的出血量，手术用时少，切口长度小的特点，且术后患者下床活动时间更早，疼痛持续的时间少，还能缩短住院时间，手术后出现的并发症也较低，但住院费用较高。

The effect of laparoscopic hernia repair and open tension-free repair in the treatment of inguinal hernia

ObjectiveTo compare the effects of laparoscopic hernia repair and open tension-free repair in the treatment of inguinal hernia. MethodsA total of 320 inguinal hernia patients in Enshi Tujia and Miao Autonomous Prefecture Central Hospital from January 2018 to December 2020 were selected and divided into laparoscopic group (160 cases) and open group (160 cases) using random number table method. The laparoscopic group underwent laparoscopic hernia repair. The open group was treated with tension-free hernia repair. The surgical blood loss, operation time, incision length, incision aesthetic score, hospital stay, ambulation time, first exhaust time, hospitalization expenses, postoperative complications, treatment effect were compared between the two groups. ResultsCompared with the open group, patients in the laparoscopic group had less surgical bleeding, short operative time and short incision length (P<0.05). The incision aesthetics score of the laparoscopic group was significantly higher than that of the open group (P<0.05), and the hospitalized time, time to get out of bed, and the first exhaust time were significantly shorter than those of the open group, but the hospitalization costs were significantly higher than that of the open group (P<0.05). There was no statistical difference in the recurrence rate and cure rate between the two groups after operation (P>0.05). The total complication rate in the laparoscopic group (5.00%) was significantly lower than that in the open group (19.38%), and the difference was statistically significant (P<0.05). ConclusionCompared with open tension-free repair, laparoscopic inguinal hernia repair can reduce the amount of bleeding during the operation, with less operation time and small incision length, and the patient gets out of bed earlier after the operation. It can shorten the duration of pain and the length of hospitalization, reduces complications after surgery, but has higher hospital costs.