摘要
目的 探究腹腔镜经腹腹膜前疝修补术(TAPP)与网塞-平片疝修补术对老年腹股沟疝患者疼痛程度及预后的影响.方法 选取2018年3月-2022年10月我院收治的78例老年腹股沟疝患者,采用随机数字表法将其分为对照组和观察组,每组各39例.对照组采用网塞-平片疝修补术,观察组采用TAPP.比较两组的手术相关指标、疼痛程度、精索静脉管径、精索静脉血流速度、并发症发生率及复发率.结果 观察组的手术时间、术中出血量、术后下床时间、肛门排气时间、正常活动时间、住院时间均优于对照组,住院费用高于对照组,术后不同时间段的疼痛评分均低于对照组,精索静脉管径、精索静脉血流速度均优于对照组,两组比较差异均有统计学意义(t=11.103、22.227、7.899、7.788、3.054、4.175、35.367、4.329、3.849、7.861、7.353、8.788、3.630,均P＜0.05);观察组并发症发生率低于对照组,两组比较差异有统计学意义(x2=3.924,P＜0.05);而两组术后复发率比较,差异无统计学意义(x2=1.103,P＞0.05).结论 老年腹股沟疝患者应用TAPP,可以改善手术相关指标,缓解疼痛程度,改善预后.
Abstract
Objective To explore the effects of laparoscopic transabdominal preperitoneal hernia repair(TAPP)and mesh plug-flat hernia repair on the pain degree and prognosis of elderly patients with inguinal hernia.Methods A total of 78 elderly patients with inguinal hernia admitted to our hospital from March 2018 to October 2022 were randomly divided into the control group and the observation group,with 39 cases in each group.The control group underwent mesh plug-flat hernia repair,while the observation group underwent laparoscopic TAPP.Surgical outcomes,pain levels,spermatic vein diameter,spermatic vein blood flow velocity,complication rates,and recurrence rates were compared between the two groups.Results The observation group showed better outcomes in terms of surgery duration,intraoperative blood loss,time to postoperative mobilization,time to first flatus,time to normal activity,and length of hospital stay;however,hospital costs were higher compared to the control group.Postoperative pain scores at different time intervals were lower in the observation group,and improvements in spermatic vein diameter and blood flow velocity were also better compared to the control group,with statistically significant differences in all comparisons(t=11.103,22.227,7.899,7.788,3.054,4.175,35.367,4.329,3.849,7.861,7.353,8.788,3.630,all P＜0.05).The complication rate in the observation group was lower than in the control group,with a statistically significant difference(x2=3.924,P＜0.05);however,there was no significant difference in the recurrence rates between the two groups(X2=1.103,P＞0.05).Conclusion Laparoscopic TAPP in elderly patients with inguinal hernia can improve surgical outcomes,alleviate pain levels,and enhance prognosis.
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