摘要
目的本研究旨在比较局麻下无张力疝修补术(开放组)与腹腔镜全腹膜外疝修补术(TEP组)在老年腹股沟疝患者中的临床应用效果。方法选取2022年1月至2024年12月于基层医院就诊的75例老年腹股沟疝患者,分为TEP组(40例)和开放组(35例),对比分析两组患者的术中术后指标及长期疼痛评分。结果TEP组在微创性(切口长度3.46±1.14 cm vs 4.82±0.41 cm)术中出血量(44.68±1.37 ml vs 52.27±2.13 ml)及早期下床活动时间(8.23±1.29 h vs 10.15±2.17 h)方面显著优于开放组(均P<0.05),但手术时间更长(70.38±12.36 min vs 52.59±3.17 min,P<0.05)。开放组在胃肠功能恢复时间(8.79±1.43 h vs 14.63±2.51 h,P<0.05)及术后3~6个月疼痛评分(VAS 0.75±0.29 vs 1.04±0.11,P<0.05)方面表现更优。两组术后1年复发率及不良事件发生率无显著差异(P>0.05)。结论TEP术式微创优势明显,适合医疗条件较好的基层医院;而开放组费用更低术后恢复更快,更适合合并心肺疾病的老年患者。临床决策需结合患者个体情况及医疗资源条件,未来需扩大样本量并延长随访以进一步验证长期疗效。
Objective This study aimed to compare the clinical efficacy of tension-free hernioplasty under local anesthesia(open group)and laparoscopic totally extraperitoneal hernioplasty(TEP group)in elderly patients with inguinal hernia in primary care hospitals.Methods A total of 75 elderly patients with inguinal hernia admitted to a primary care hospital between January 2022 and December 2024 were enrolled and divided into the TEP group(n=40)and the open group(n=35).Intraoperative and postoperative indicators,as well as long-term pain scores,were compared between the two groups.Results The TEP group demonstrated signifi⁃cant advantages in minimally invasive outcomes,including shorter incision length(3.46±1.14cm vs 4.82±0.41cm,P<0.05),reduced intraoperative blood loss(44.68±1.37ml vs 52.27±2.13ml,P<0.05),and earlier ambulation time(8.23±1.29h vs 10.15±2.17h,P<0.05).However,the TEP group required a longer operative time(70.38±12.36min vs 52.59±3.17min,P<0.05).In contrast,the open group showed superior gastrointestinal func⁃tion recovery time(8.79±1.43h vs 14.63±2.51h,P<0.05)and lower pain scores at 3-6 months postoperatively(VAS 0.75±0.29 vs 1.04±0.11,P<0.05).No significant differences were observed in the 1-year recurrence rate or adverse event incidence between the two groups(P>0.05).Conclusion The TEP technique offers notable minimally invasive benefits and is suitable for primary care hospitals with adequate medical resources.Conversely,the open procedure is more cost-effective,facilitates faster recovery,and is preferable for elderly patients with cardiopulmonary comorbidities.Clinical decision-making should consider individual patient conditions and avail⁃able medical resources.Future studies with larger sample sizes and extended follow-up periods are warranted to validate long-term outcomes.
作者
王俊
尹明
WANG Jun;YIN Ming(Qintong People’s Hospital;The Affiliated Taizhou People’s Hospital of Nanjing Medical University,Taizhou Jiangsu 225300,China)
出处
《泰州职业技术学院学报》
2025年第5期94-96,107,共4页
Journal of Taizhou Polytechnic College
关键词
老年腹股沟疝
腹腔镜全腹膜外疝修补术
局麻下无张力疝修补术
elderly inguinal hernia
laparoscopic totally extraperitoneal hernioplasty
tension-free hernioplasty under local anesthesia
