腹腔镜完全腹膜外疝修补术和改良Kugel手术治疗成人腹股沟疝的效果研究

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摘要目的对比研究腹腔镜完全腹膜外疝修补术（TEP）和改良Kugel手术治疗成人腹股沟疝的疗效。　方法回顾性分析我院2012年6月～2014年6月收治的148例成人腹股沟疝患者的临床资料，将其随机分为两组，其中TEP组72例，改良Kugel组76例。比较两组患者的住院费用、手术时间、术后住院时间、术后切口疼痛持续时间及术后并发症；随访12～24个月，观察术后复发情况。　结果两组手术均成功，TEP组住院费用（8564.5±609.5）元，改良Kugel组住院费用（6708.5±854.4）元，两组比较差异有统计学意义（P＜0.01）；TEP组术后住院时间和术后切口疼痛持续时间短于改良Kugel组，差异有统计学意义（P＜0.01）；两组手术时间和术后并发症中阴囊血肿或积液、尿潴留、修补区域疼痛比较，差异无统计学意义（P＞0.05），但在并发症中血清肿的发生率TEP组（15.3%）明显高于改良Kugel组（2.6%），差异有统计学意义（P＜0.01）；两组术后均无复发。　结论 TEP组住院总费用高于改良Kugel组，但行TEP的患者具有术后恢复快、出院时间早、术后切口疼痛持续时间短等优点，因此行TEP是安全的、可行的。

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	胡安然
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	徐书楷

关键词 ：腹股沟疝, 腹腔镜, TEP, 改良Kugel

Abstract：Objective To compare and study the curative effects of laparoscopic totally extraperitaneal prosthetic （TEP）and modified Kugel surgery in the treatment of adult inguinal hernia.Methods Clinical data of 148 adult patients with inguinal hernia who were admitted to the department of general surgery in our hospital from June 2012 to June 2014 were retrospectively analyzed.All the patients were randomly divided into two groups，with 72 patients in TEP group and 76 patients in the modified Kugel group.Costs of hospitalization，surgery time，postoperative length of stay，lasting time of postoperative incision pain and postoperative complications were compared between the two groups of patients.After 12～24 months of follow-up visit，postoperative relapses were observed.Results The surgeries in the two groups were both successful.The cost of hospitalization in the TEP group was（8564.5±609.5）yuan，and the cost in the modified Kugel group was（6708.5±854.4）yuan.The cost of hospitalization in the TEP group was higher，and the difference was statistically significant（P＜0.01）；in the comparison of postoperative length of stay and lasting time of postoperative incision pain between the two groups，TEP groups were both shorter，and the differences were statistically significant（P＜0.01）.The differences of the comparison of surgery time and postoperative complications such as hematoma or effusion of the scrotum，urinary retention and pain in the patch regions were not statistically significant（P＞0.05）.However，the incidence rate of seroma in the TEP group　（15.3%）was significantly higher than that in the modified Kugel group（2.6%），and the difference was statistically significant（P＜0.01）.There was no relapse in both the two groups after the surgery.Conclusion The total cost of hospitalization in the TEP group is higher than that in the modified Kugel group，but patients receiving TEP have the advantages of fast postoperative recovery，early discharge time，short lasting time of postoperative incision pain.Therefore，TEP is a safe and feasible method.

Key words： Inguinal hernia Laparoscope TEP Modified Kugel

引用本文:

胡安然;黄可出;王永忠;徐书楷. 腹腔镜完全腹膜外疝修补术和改良Kugel手术治疗成人腹股沟疝的效果研究[J]. 中国当代医药, 2016, 23(10): 21-23转26.
HU An-ran;HUANG Ke-chu;WANG Yong-zhong;XU Shu-kai. Comparison of the effects of laparoscopic totally extraperitaneal prosthetic and modified Kugel surgery in the treatment of adult inguinal hernia. 中国当代医药, 2016, 23(10): 21-23转26.

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