国际医药卫生导报 ›› 2025, Vol. 31 ›› Issue (17): 2912-2916.DOI: 10.3760/cma.j.cn441417-20241210-17018

• 临床研究 • 上一篇    下一篇

针对性入路修补术在原发性或切口侧腹壁疝患者中的应用

洪浩斌  张博  周章鹏  黄昌宇  马萍   

  1. 咸阳市第一人民医院胃肠外科,咸阳 712000

  • 收稿日期:2024-12-10 出版日期:2025-09-01 发布日期:2025-09-25
  • 通讯作者: 张博,Email:2227189010@qq.com
  • 基金资助:

    陕西省科技计划(2024JC-YBMS-586);咸阳市重点研发计划(L2022ZDYFSF035)

Application of targeted approach repair in patients with primary or incisional lateral abdominal wall hernia

Hong Haobin, Zhang Bo, Zhou Zhangpeng, Huang Changyu, Ma Ping   

  1. Department of Gastrointestinal Surgery, Xianyang First People's Hospital, Xianyang 712000, China

  • Received:2024-12-10 Online:2025-09-01 Published:2025-09-25
  • Contact: Zhang Bo, Email: 2227189010@qq.com
  • Supported by:

    Shaanxi Province Science and Technology Plan (2024JC-YBMS-586); Xianyang City Key Research and Development Project (L2022ZDYFSF035)

摘要: 目的 分析针对性入路修补术与常规腹腔内修补术在原发性或切口侧腹壁疝患者中的应用价值。方法 采用回顾性分析,选取2021年3月至2024年3月于咸阳市第一人民医院接受手术治疗的125例侧腹壁切口疝患者,所有患者均采用腹腔镜修补术治疗。按手术方式的不同分为对照组(60例)与研究组(65例)。对照组行常规腹腔内修补术治疗,研究组行针对性入路修补术治疗。对照组:男30例、女30例,年龄45~69(53.45±5.67)岁;原发性腹壁疝15例、切口腹壁疝45例。研究组:男33例、女22例,年龄40~68(53.68±5.71)岁;原发性腹壁疝18例、切口腹壁疝47例。比较两组患者术中出血量、手术时间、疝环横径和术后视觉模拟评分法(Visual Analogue Scale,VAS)评分、住院时间、并发症、复发情况。采用t检验、χ2检验进行统计分析。结果 两组患者术中出血量、手术时间、疝环横径比较[(10.95±3.33)ml比(12.24±5.28)ml、(161.25±52.18)min比(145.27±41.06)min、(6.71±2.02)cm比(6.85±2.19)cm],差异均无统计学意义(t=1.647、1.892、0.372,均P>0.05)。研究组在术后第1天静息状态时VAS评分低于对照组[(2.45±0.53)分比(2.82±0.85)分],住院时间短于对照组[(4.80±1.32)d比(8.32±2.06)d],差异均有统计学意义(t=2.944、11.463,均P<0.05)。随访6个月,研究组与对照组术后并发症发生率、复发率比较[6.15%(4/65)比0%(0/60)、0%(0/65)比5.00%(3/60)],差异均无统计学意义(χ2=2.086、1.537,均P>0.05)。结论 与常规腹腔内修补术相比,针对性入路修补术用于原发性或切口侧腹壁疝患者效果良好,患者术后疼痛程度较低、术后恢复时间短,预后更好。

关键词:

腹壁疝, 原发性, 切口疝, 腹腔镜, 不同入路

Abstract:

Objective To analyze the application value of targeted approach repair and conventional intraperitoneal repair in patients with primary or incisional abdominal wall hernia. Methods Retrospective analysis was used to select 125 patients with lateral abdominal incisional hernia who underwent surgical treatment in Xianyang First People 's Hospital from March 2021 to March 2024. All patients underwent laparoscopic repair.According to the different surgical methods, they were divided into control group (60 cases) and study group (65 cases).The control group underwent routine intraperitoneal repair, and the study group underwent targeted approach repair.Control group: 30 males and 30 females, aged 45-69 (53.45±5.67) years ;There were 15 cases of primary abdominal wall hernia and 45 cases of incisional abdominal wall hernia.Study group : 33 males and 22 females, aged 40-68 (53.68±5.71) years ;There were 18 cases of primary abdominal wall hernia and 47 cases of incisional abdominal wall hernia.The intraoperative blood loss, operation time, transverse diameter of hernia ring, postoperative Visual Analogue Scale (VAS) score, postoperative hospital stay, postoperative complications and postoperative recurrence were compared between the two groups.Statistical analysis was conducted using t test and χ2 test. Results The intraoperative blood loss, operation time and transverse diameter of hernia ring were compared between the two groups [(10.95±3.33) ml vs. (12.24±5.28) ml, (161.25±52.18) min vs.(145.27±41.06) min, (6.71±2.02) cm vs. (6.85±2.19) cm], the differences were not statistically significant (t=1.647,1.892,0.372; all P>0.05). The VAS score at rest on the first day after operation in the study group was lower than that in the control group [(2.45±0.53) points vs. (2.82±0.85) points], and the hospitalization time was shorter than that in the control group [ (4.80±1.32) d vs. (8.32±2.06) d], the differences were statistically significant (t=2.944,11.463; all P<0.05). After 6 months of follow-up, the incidence of postoperative complications and recurrence rates were compared between the study group and the control group [6.15%(4/65) vs. 0%(0/60), 0%(0/65) vs. 5.00%(3/60)], the differences were not statistically significant (χ2=2.086,1.537; both P>0.05). Conclusion Compared with conventional intraperitoneal repair, targeted approach repair for patients with primary or incisional abdominal wall hernia has lower postoperative pain, shorter postoperative recovery time and better prognosis.

Key words:

Abdominal hernia, Primary, Incisional hernia, Laparoscope, Different approaches