TAPP与Li-chtenstein疝修补术治疗成人复发性腹股沟疝的疗效及术后疼痛SF-MPQ评分变化-现代医学

TAPP与Li-chtenstein疝修补术治疗成人复发性腹股沟疝的疗效及术后疼痛SF-MPQ评分变化

单位：东南大学附属中大医院江北院区/南京市大厂医院, 江苏南京 210000

分类号：R656.2+1

出版年·卷·期（页码）：2019·47·第二期（117-122）

摘要：

目的：对比分析腹腔镜经腹腔腹膜前疝修补术（TAPP）与Li-chtenstein修补术治疗成人复发性腹股沟疝的疗效及对患者术后SF-MPQ评分的影响。方法：收集2014年1月至2017年1月我院收治的成人复发性腹股沟疝患者99例随机分为两组：观察组53例行TAPP治疗，对照组40例行Li-chtenstein修补术。对比两组围手术期指标，术后1 d、7 d、3个月、6个月、12个月，采用简版McGill疼痛问卷（SF-MPQ）评价疼痛情况，统计术后慢性疼痛发生率、复发率。结果：两组的手术时间比较，差异无统计学意义（P>0.05）；观察组的术中出血量、术后首次下床活动时间、住院时间均较对照组明显降低（P<0.05）；术后1 d、7 d、3个月、6个月，观察组的SF-MPQ评分显著低于对照组（P<0.05）；术后12个月，组间SF-MPQ评分比较，差异无统计学意义（P>0.05）；观察组术后慢性疼痛及总并发症发生率分别为3.39%、8.47%，显著低于对照组的15.00%、27.50%（P<0.05）；观察组术后随访未再复发，对照组1例（2.50%）复发，组间比较差异无统计学意义（P>0.05）。结论：TAPP是治疗成人复发性腹股沟疝的有效术式，术后康复快、安全性好且慢性疼痛少。

Objective:To compare the efficacy of laparoscopic trans-abdominal preperitoneal prosthetic repair(TAPP) and Li-chtenstein inguinal herniorrhaphy for adult recurrent inguinal hernia and the influence on postoperative pain SF-MPQ score. Methods:99 casesof adultswith recurrent inguinal hernia from January 2014 to January 2017 in our hospital were enrolled, who were randomly divided into two groups:59 patients in the observation grouptreated with laparoscopic trans-abdominal preperitoneal prosthetic repair(TAPP), 40 patients in the control group treated with Li-chtenstein inguinal herniorrhaphy.The perioperative indicators were compared between the two groups,the Short-form MPQ(SF-MPQ) was used to evaluate the painat on the 1^st day,7^th day,in 3^rd month,6^th month and 12^th month after surgery,the incidence of postoperative chronic pain and recurrence rate was compared. Results:There was no significant difference in the operative time between the two groups(P>0.05),the intraoperative blood loss, out-of-bed activity time and the hospital stay in the observation group were significantly lower than those in the control group(P<0.05). On the1^st day,7^th day,3^rd month, in the 6^th month after surgery, SF-MPQ score in the observation group was significantly lower than that of the control group(P<0.05),but there was no significant difference in the SF-MPQ score in the 12^th month after surgery between the two groups(P>0.05);The postoperative chronic pain and total complication rate in the observation group were 3.39% and 8.47%, respectively, which were significantly lower than 15.00% and 27.50% in the control group(P<0.05); No more recurrence was found in the observation group,and one patient(2.50%) recurrence,there was no significant difference between the two groups(P>0.05). Conclusion:TAPP is an effective treatment for adult recurrent inguinal hernia, for itsrapid recovery, good safety and less chronic pain.

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