文章摘要

快速康复模式下的腹腔镜腹股沟疝修补术

作者: 1黄耿文, 1申鼎成, 1何文, 1杨柳, 1周书毅, 1阳建怡, 1纪连栋, 1魏伟
1 中南大学湘雅医院 普通外科，湖南 长沙 410008
通讯: 黄耿文 Email: gengwenhuang@outlook.com
DOI: 10.3978/.10.3978/j.issn.1005-6947.2016.10.017

摘要

目的：探讨快速康复外科（ERAS）模式下的腹腔镜腹股沟疝修补术的有效性和安全性。方法：回顾性分析2013年7月―2016年9月湘雅医院普通外科行标准化ERAS模式下腹腔镜腹股沟疝修补术的360例患者临床资料。结果：全组中位手术时间68（30~130）min，单侧疝中位手术时间48 min，双侧疝中位手术时间91 min。术后并发症发生率为8.9%（32/360），主要包括尿潴留15例（4.2%），血清肿25例（6.9%），无伤口感染和住院期死亡。术后中位住院时间1 d。术后次日数字评分法（NRS）疼痛评分为（1.8±1.2）分，年龄<65岁者NRS评分明显高于年龄≥65岁者（P=0.01）。术后1个月，中位腹股沟疼痛调查表（IPQ）评分为1.6（0~8）分。结论：ERAS模式下的腹腔镜腹股沟疝修补术安全和有效，且并发症发生率低，患者满意度高。
关键词： 疝，腹股沟/外科学 疝修补术，腹腔镜 快速康复外科

Laparoscopic inguinal hernia repair with enhanced recovery after surgery protocols

Authors: 1HUANG Gengwen, 1SHEN Dingcheng, 1HE Wen, 1YANG Liu, 1ZHOU Shuyi, 1YANG Jianyi, 1JI Liandong, 1WEI Wei
1 Department of General Surgery, Xiangya Hospital, Central South University, Changsha 410008, China

CorrespondingAuthor:HUANG Gengwen Email: gengwenhuang@outlook.com

Abstract

Objective: To investigate the safety and efficacy of laparoscopic inguinal hernia repair with utilization of the enhanced recovery after surgery (ERAS) protocols. Methods: The clinical data of 360 patients undergoing laparoscopic inguinal hernia repair with standard ERAS protocols between July 2013 and September 2016 in Department of General Surgery of Xiangya Hospital were retrospectively analyzed. Results: The median operative time for the entire group was 68 (30 to130) min, for unilateral inguinal hernia was 48 min and for bilateral inguinal hernia was 91 min. The incidence of postoperative complications was 8.9% (32/360), which mainly included urinary retention in 15 cases (4.2%) and seroma in 25 cases (6.9%). No wound infection or perioperative death occurred. The median length of postoperative hospital stay was 1 d. The pain score measured by numeric rating scale (NRS) on the first postoperative day was 1.8±1.2, and the NRS score in the patients under 65 years of age was significantly higher than in those over 65 years of age (P=0.01). The score of Inguinal Pain Questionnaire (IPQ) was 1.6 (0 to 8) at one month postoperatively. Conclusion: Laparoscopic inguinal hernia repair with utilization of ERAS protocols is safe and effective, with low incidence of postoperative complications and high patient satisfaction.
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