摘要
目的 探讨膜解剖理论在成人腹股沟全腹膜外修补术(TEP)斜疝疝囊分离中的应用价值及临床效果。方法 选择2019年4月—2021年6月行腹股沟TEP手术的180例斜疝患者为研究对象,其中观察组83例运用膜解剖理论进行疝囊主动切开,对照组97例按传统方法常规剥离疝囊,对比分析两组患者手术时间、术后住院时间、术后12 h疼痛评分、手术室费用、术中副损伤(输精管、精索血管、肠管)及并发症发生率(血清肿、切口感染、慢性疼痛)等临床指标。结果 两组患者手术均顺利完成,无中转开放。观察组手术时间(48.6±13.5)min较对照组(62.8±12.2)min显著缩短,差异有统计学意义(t=-9.714,P<0.05);两组患者术后住院时间、术后12 h疼痛评分、手术室费用及术中副损伤比较差异均无统计学意义(P>0.05)。术后均随访6个月,两组患者均无肠梗阻、疝复发、慢性疼痛、补片感染等严重并发症发生。结论 将膜解剖理论运用于TEP术中有助于加深对手术局部解剖的认识,根据其理论可选择适合的疝囊分离方式,在不同的解剖区域迅速找准层次,把TEP做的更好、更快、更简单,使患者获益。
Objective To investigate the application value and clinical effect of membrane anatomy theory in the separation of hernia sac in adult total extraperitoneal inguinal repair(TEP).Methods One hundred and eighty patients with inguinal hernia who underwent TEP surgery from April 2019 to June 2021 were selected as the study subjects.Among them,83 patients in the observation group were performed active incision of hernia sac based on membrane anatomy theory,while 97 patients in the control group were performed traditional methods for routine dissection of the hernia sac.The operative time,postoperative hospital stay,postoperative pain score 12 h,operating room cost,intraoperative collateral injury(vas deferens,spermatic vessels,intestinal tract),incidence of complications(seroma,incision infection,chronic pain)and other clinical indicators were compared between the two groups.Results The operation was completed successfully in the two groups,without any conversion to open surgery.The operation time of the observation group was significantly shorter than that of the control group(48.6±13.5 min vs.62.8±12.2 min;t=-9.714,P<0.05).There were no statistically significant differences in postoperative hospital stay,postoperative 12 h pain score,operating room cost and intraoperative secondary injuries between the two groups(P>0.05).All patients were followed up for 6 months after surgery,and no ileus,recurrence,chronic pain,mesh infection and other serious complications occurred in the two groups.Conclusion The application of membrane anatomy theory in TEP is conducive to the understanding of surgical regional anatomy.According to the theory,the most suitable separation method of hernia sac can be selected,and the levels can be quickly determined and identified in different regions,so that TEP can be performed in a better,faster and simpler way to benefit patients.
作者
刘龙虎
张琴
李洋
赵士宇
徐继宗
LIU Longhu;ZHANG Qin;LI Yang;ZHAO Shiyu;XU Jizong(People’s Hospital of Yuan’an County,Yuan’an 444200,China;The Second People’s Hospital,Three Gorges University,Yichang 443000,China)
出处
《现代医院》
2023年第5期809-811,815,共4页
Modern Hospitals
基金
湖北省科技计划项目(自然科学基金)(2018CFB727)。
关键词
膜解剖
腹股沟斜疝
TEP
疝囊分离
应用研究
Membrane dissection
Oblique inguinal hernia
TEP
Hernia sac separation
Application research
