中华普外科手术学杂志(电子版) ›› 2025, Vol. 19 ›› Issue (03) : 321 -324. doi: 10.3877/cma.j.issn.1674-3946.2025.03.024. × 扫一扫
论著
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Ligang Nan1, Junyan Wang2, Xi Wu2, Xiaojing Wu2, Jiao Liang3, Lei Guan4, Xianglong Duan2,†()
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南李刚, 王君妍, 武曦, 伍晓晶, 梁姣, 关蕾, 段降龙. 老年患者开放腹膜前无张力疝修补术与腹腔镜经腹腹膜前疝修补术的临床疗效研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(03): 321-324.
Ligang Nan, Junyan Wang, Xi Wu, Xiaojing Wu, Jiao Liang, Lei Guan, Xianglong Duan. Clinical efficacy study of open preperitoneal tension-free herniorrhaphy and laparoscopic transabdominal preperitoneal herniorrhaphy in elderly patients[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(03): 321-324.
目的
探讨老年患者开放腹膜前无张力疝修补术与腹腔镜经腹腹膜前疝修补术的临床疗效研究。
方法
选取 2015年1月至 2017年11月行手术治疗的腹股沟疝患者233例，按照术式不同分为开放手术组（n=117例）和腔镜手术组（n=116例）。使用 SPSS21.0统计软件进行数据分析，围手术期各项指标等计量资料以（±s）表示，采用独立样本t检验；术后并发症等计数资料采用χ2检验；单因素和多因素分析采用Logistics回归分析。P＜0.05为差异有统计学意义。
结果
开放手术组患者手术时间、麻醉时间、术后排气时间、术后排便时间和住院费用较腔镜手术组患者明显缩短或减少（P＜0.05）。开放手术组患者术后并发症恶心呕吐、谵妄、肠麻痹和肠梗阻发生率明显低于腔镜手术组患者（P＜0.05）。通过单因素分析发现，手术时间≥100min、腔镜手术方式是影响术后远期肠梗阻发生的影响因素，多因素分析发现，腔镜手术方式不是独立危险因素（P＜0.05）。
结论
开放腹膜前无张力疝修补术更适宜老年患者，术后近远期并发症发生率低，修补效果等同于腔镜手术，且经济，易于掌握，适合基层医疗机构推广。
Objective
To explore the clinical efficacy of open preperitoneal tension-free herniorrhaphy and laparoscopic transabdominal preperitoneal herniorrhaphy in elderly patients.
Methods
A total of 233 patients with inguinal hernia who underwent surgical treatment from January 2015 to November 2017 were selected.According to different surgical methods，they were divided into the open surgery group（n=117 cases） and the laparoscopic surgery group （n=116 cases）.The statistical software SPSS21.0 was used for data analysis.Measurement data such as various perioperative indexes were expressed as （±s），and independent samples t test was used； counting data such as postoperative complications were analyzed by chisquare test； univariate and multivariate analyses were performed by Logistics regression analysis.A P value less than 0.05 was considered statistically significant.
Results
The operation time，anesthesia time，postoperative exhaust time，postoperative defecation time and hospitalization cost of the patients in the open surgery group were significantly shorter or lower than those of the patients in the laparoscopic surgery group （P＜0.05）.The incidences of postoperative complications such as nausea and vomiting，delirium，ileus and intestinal obstruction in the open surgery group were significantly lower than those in the laparoscopic surgery group（P＜0.05）.Through univariate analysis，it was found that the operation time ≥ 100 min and the laparoscopic surgical method were influencing factors for the occurrence of long-term postoperative intestinal obstruction.Multivariate analysis showed that the laparoscopic surgical method was not an independent risk factor （P＜0.05）.
Conclusion
Open preperitoneal tension-free herniorrhaphy is more suitable for elderly patients.It has a low incidence of both short-term and long-term postoperative complications.The repair effect is equivalent to that of laparoscopic surgery.It is economical，easy to master，and suitable for promotion in primary medical institutions.