论文部分内容阅读
目的:研究腹腔镜经腹腹膜前疝修补术（TAPP）式与网塞修补术式对腹股沟斜疝患者性功能的影响。方法:选取2018年1月至2019年10月在解放军联勤保障部队第922医院就诊的腹股沟斜疝患者104例，按照随机数字表法分为常规组和TAPP组，每组52例。常规组采用网塞修补术治疗，TAPP组采用腹腔镜TAPP治疗，术后6个月采用国际勃起功能指数-5（IIEF-5）评估患者性功能，术后1个月采用疼痛视觉模拟量表（VAS）评估患者疼痛情况，统计两组手术相关指标、手术并发症发生情况，并进行比较。结果:术后6个月两组IIEF-5评分高于术前，睾丸体积、睾丸动脉最大血流速度低于术前，差异有统计学意义（n P<0.05）。术后6个月TAPP组IIEF-5评分高于常规组[（23.86 ± 1.5）分比（21.45 ± 3.85）分]，睾丸体积、睾丸动脉最大血流速度高于常规组[（9.65 ± 0.08） cmn 3比（9.39 ± 0.09） cmn 3、（3.83 ± 1.05） cm/s比（2.88 ± 0.36） cm/s]，差异有统计学意义（n P<0.05）。术后1个月，两组VAS评分均低于术前，并且TAPP组VAS评分低于常规组[（1.65 ± 0.35）分比（2.78 ± 0.39）分]，差异均有统计学意义（n P<0.05）。TAPP组手术时间长于常规组[（44.35 ± 6.26） min比（41.80 ± 5.95） min]，术中出血量、下床活动时间、住院时间低于常规组[（54.66 ± 8.98）ml比（73.25 ± 15.25） ml、（12.75 ± 2.42） h比（23.55 ± 3.66） h、（3.25 ± 1.01） d比（7.85 ± 1.44） d]，差异均有统计学意义（n P<0.05）。TAPP组并发症发生率低于常规组[3.85% （2/52）比21.15%（11/52）]，差异有统计学意义（n χ2=7.121，n P<0.05）。n 结论:TAPP术式治疗腹股沟斜疝患者与网塞修补术式相比，能改善患者性功能，缓解患者疼痛，提高治疗效果，减少并发症发生。“,”Objective:To study the effect of laparoscopic transabdominal preperitoneal (TAPP) and mesh plug repair on the sexual function of patients with indirect inguinal hernia.Methods:One hundred and four patients with indirect inguinal hernia who were treated in the No.922 Hospital of PLA Joint Logistics Support Force from January 2018 to October 2019 were selected and divided into two groups according to the method of random number table: routine group and TAPP group, with 52 cases in each group. The routine group was treated with mesh plug repair, and the TAPP group was treated with TAPP. The international erectile function index-5 (IIEF-5) was used to evaluate the sexual function of the patients after operation for 6 months, the visual analog pain scale (VAS) was used to evaluate the pain after operation for 1 month, and the relevant indexes of the operation and the incidence of complications were compared.Results:The IIEF-5 scores at 6 months after operation in two groups was higher than that before operation, the testicular volume and the maximum blood flow velocity of testicular artery in two groups were lower than those before operation, and the differences were statistically significant (n P<0.05); the IIEF-5 scores at 6 months after operation in the TAPP group was higher than that in the routine group [(23.86 ± 1.5) scores vs. (21.45 ± 3.85) scores], and the testicular volume and the maximum blood flow velocity of testicular artery were higher than those in the routine group [(9.65 ± 0.08) cmn 3 vs. (9.39 ± 0.09) cmn 3, (3.83 ± 1.05) cm/s vs. (2.88 ± 0.36) cm/s], and the differences were statistically significant (n P<0.05). One month after operation, the pain scores of two group were lower than that before operation, and the pain scores of TAPP group was lower than that of routine group [(1.65 ± 0.35) scores vs. (2.78 ± 0.39) scores], and the differences were statistically significant (n P<0.05). The operation time of TAPP group was higher than that of routine group [(44.35 ± 6.26) min vs. (41.80 ± 5.95) min], the bleeding volume, the time of getting out of bed, the time of hospitalization of TAPP group were lower than those of routine group [(54.66 ± 8.98) ml vs. (73.25 ± 15.25) ml, [(12.75 ± 2.42) h vs. (23.55 ± 3.66) h], (3.25 ± 1.01) d vs. (7.85 ± 1.44) d], and the differences were statistically significant (n P<0.05). The incidence of operation complications of TAPP group was lower than that of routine group [3.85%(2/52) vs. 21.15%(11/52)], and the difference was statistically significant (n χ2=7.121, n P<0.05).n Conclusions:Compared with conventional hernia repair, laparoscopic hernia repair can improve the sexual function, relieve the pain, improve the therapeutic effect and reduce the complications.