论文部分内容阅读
目的：比较腹腔镜微创术式与 Lichtenstein 修补术治疗老年复发性腹股沟疝的临床疗效，为临床选择适合的治疗方法提供依据。方法选择29例老年复发性腹股沟疝患者，采用腹腔镜微创术式治疗（研究组）；另外选择29例患者采用 Lichtenstein 修补术治疗（对照组），比较两组治疗的平均手术时间、术后视觉模拟疼痛评分与住院时间等。结果研究组患者根据前次手术的方式，分为三种不同微创术式治疗，分别为经腹腹膜前腹腔镜腹股沟疝修补术（TAPP）20例，腹腔镜全腹膜外疝修补术（TEP）4例，腹腔镜腹腔内补片植入术（IPOM）5例；研究组患者手术均能顺利完成，无中转开腹的患者。平均手术时间（43.32±12.83）min，术中出血量（53.3±10.3）ml，术后第1天平均视觉模拟疼痛评分（VAS）为（2.34±1.21）分，术后平均住院时间（2.1±1.1）天，均显著低于对照组（ P ﹤0.05）。结论腹腔镜治疗老年复发性腹股沟疝具有更好的治疗效果，其中 TAPP 术式是目前使用最为广泛的腹腔镜复发性腹股沟疝的修补方法，值得临床运用。“,”Objective To evaluate the clinical efficacy of surgical procedures in laparoscopic repair and Lichtenstein hernioplasty in elder-ly patients with recurrent inguinal hernia. Methods A total of 29 elderly patients with recurrent inguinal hernia treated by minimally invasive lap-aroscopic surgery were allocated in study group. Three different kinds of minimally invasive surgical procedures were undertaken and their results were analyzed. Results According to the procedures of surgical treatment,a total of 20 cases were performed with TAPP,four cases were chosen with TEP for treatment and five cases were applied with IPOM for treatment. All these patients were successfully completed the operation,without transition to laparotomy. The mean operating time was 43. 32 ± 12. 83 min and amount of blood loss was 53. 3 ± 10. 3 ml. The average visual ana-log pain scales(VAS)in first postoperative day were 2. 34 ± 1. 21 points,and mean postoperative hospital stay was 2. 1 ± 1. 1 days. All patients could resume basic activities within 2 weeks. Conclusion TAPP is the most currently applied procedure for laparoscopic repair of recurrent ingui-nal hernia in elderly patients,hence it is worthy to be clinically applied.