不同通路腹腔镜腹股沟斜疝修补术对比性临床研究.docVIP

不同通路的腹腔镜腹股沟斜疝修补术的对比性临床研究 　　[摘要]目的 比较经下肢皮下通路和经皮全腹膜外通路两种不同途径的腹腔镜下腹股沟斜疝修补术在腹股沟斜疝治疗中的临床效果。方法 选择2013年9月～2015年8月因腹股沟斜疝在我院治疗的患者86例，随机分为观察组和对照组，各43例。观察组患者采用下肢皮下通路的腹腔镜下腹股沟斜疝修补术（LHR-L），对照组患者采用经皮全腹膜外通路的腹腔镜下腹股沟斜疝修补术治疗。比较两组的临床效果和并发症发生情况。结果 86例患者均成功完成手术。观察组的手术时间、术中出血量和住院费用均少于对照组，差异均有统计学意义（P0.05）。术后6、24、48 h，观察组的VAS疼痛评分均低于对照组（P0.05）；观察组的SF-36评分均高于对照组（P0.05）。观察组近期并发症发生率为4.66%，低于对照组的18.60%（P0.05）。结论 LHR-L治疗腹股沟斜疝具有操作简便、治疗效果确切、术后并发症少且恢复快的优点，可以在临床进一步推广。 　　[关键词]腹股沟斜疝；腹腔镜；经下肢皮下通路 　　[中图分类号] R656.21 [文献标识码] A [文章编号] 1674-4721（2017）05（c）-0019-04 　　[Abstract]Objective To compare the clinical efficacy of laparoscopic hernia repair via the limb subcutaneous approach （LHR-L） and laparoscopic hernia repair via the total extraperitoneal approach （LHR-TEP）.Methods A total of 86 patients with inguinal indirect hernia in our hospital from September 2013 to August 2015 were selected and randomly divided into observation group and control group，43 cases in each group.Patients in the observation group were given LHR-L and control group were given LHR-TEP.The clinical efficacy and complications of two group were observed and compared.Results All the 86 cases finished operation successfully.The operation time，blood loss within operation，and hospitalization expenses in observation group were less than those of control group with difference being statistically significant（P0.05）.At the time of 6，24，and 48 h after operation，the VAS pain scores of observation group was lower than those of control group （P0.05），and the SF-36 scores of observation group was higher than that of control group （P0.05）.The recent complication of observation group （4.66%） was lower than those of control group （18.60%） （P0.05）.Conclusion LHR-L has the advantage of simple handling，definite efficacy，less postoperative complications and faster recovery，and can be promoted clinically. 　　[Key words]Inguinal indirect hernia；Laparoscopic surgery；Via the limb subcutaneous approach 　　腹股?闲别奘峭饪瞥＜?的腹外疝，发病率占全部腹外疝的90%[1]，男性发病率高于女性。腹股沟斜疝的发生