经腹腔镜腹膜前间隙无张力修补术与巴西尼疝修补术治疗腹股沟疝的疗效比较

Comparative study on the efficacy of laparoscopic transabdominal preperitoneal repair and Bassini herniorrhaphy in the treatment of inguinal hernia

摘要:

目的 探究经腹腔镜腹膜前间隙无张力修补术（TAPP）与巴西尼（Bassini）疝修补术治疗腹股沟疝的疗效比较。方法 选择2021年1月－2024年12月该院收治的腹股沟疝患者107例，采用随机数表法，将患者分为Bassini组（采用Bassini疝修补术，53例）和TAPP组（采用TAPP手术修补，54例）。比较两组患者手术相关指标、疼痛程度、应激指标水平、生活质量、康复效果和并发症发生率。结果 Bassini组手术时间明显短于TAPP组，术中出血量明显多于TAPP组，住院时间明显长于TAPP组，差异均有统计学意义（P < 0.05）；两组患者术后视觉模拟评分法（VAS）评分呈先升后降趋势，术后3和7 d TAPP组VAS评分明显低于Bassini组，差异均有统计学意义（P < 0.05）；两组患者术后3 d皮质醇和去甲肾上腺素水平明显高于术前，且Bassini组明显高于TAPP组，差异均有统计学意义（P < 0.05）；TAPP组总有效率为98.15%，明显高于Bassini组的83.02%，差异有统计学意义（P < 0.05）；两组患者术后1个月健康调查量表36（SF-36）评分明显高于术前，且TAPP组明显高于Bassini组，差异均有统计学意义（P < 0.05）；TAPP组并发症总发生率为3.70%，明显低于Bassini组的18.87%，差异有统计学意义（P < 0.05）。结论 TAPP较Bassini疝修补术，可有效地缩短住院时间，减少术中出血量，减轻术后疼痛程度和应激反应，提高患者术后生活质量，增加康复效果，降低并发症发生率。值得临床推广应用。

Abstract:

Objective To compare the therapeutic effects of laparoscopic transabdominal preperitoneal repair (TAPP) and Bassini herniorrhaphy in the treatment of inguinal hernia.Methods 107 patients with inguinal hernia from January 2021 to December 2024 were selected and divided into the Bassini group (53 cases were repaired by Bassini herniorrhaphy) and the TAPP group (54 cases were repaired by TAPP) by random number table method. The surgical-related indicators, pain degree, stress index levels, quality of life, rehabilitation effect and incidence of complications of the two groups of patients were compared.Results The operation time of the Bassini group was significantly shorter than that of the TAPP group, the intraoperative blood loss was significantly more than that in the TAPP group, and the hospital stay was significantly longer than that in the TAPP group, the differences were statistically significant (P < 0.05). The visual analogue scale (VAS) score of the two groups of patients after surgery showed a trend of first increasing and then decreasing. The VAS scores of the TAPP group at 3 and 7 days after surgery were significantly lower than those of the Bassini group, and the differences were statistically significant (P < 0.05). The levels of cortisol and norepinephrine in both groups of patients 3 days after the operation were significantly higher than those before the operation, and the Bassini group was significantly higher than the TAPP group, the differences were statistically significant (P < 0.05). The total effective rate of the TAPP group was 98.15%, significantly higher than that of the Bassini group (83.02%), and the difference was statistically significant (P < 0.05). The Short Form 36 (SF-36) score of the two groups of patients one month after the operation was significantly higher than that before the operation, and the TAPP group was significantly higher than the Bassini group, the differences were statistically significant (P < 0.05). The incidence of complications in the TAPP group was 3.70%, significantly lower than 18.87% in the Bassini group, and the difference was statistically significant (P < 0.05).Conclusion Compared with Bassini herniorrhaphy, TAPP can effectively shorten the hospital stay, reduce intraoperative blood loss, lower postoperative pain and stress response, improve the postoperative quality of life of patients, enhance rehabilitation effect and reduce the incidence of complications. It is worthy of clinical promotion and application.