摘要
目的比较腹腔镜与开放腹股沟疝修补术治疗65岁以上老年患者的疗效。方法本文分析2011年7月至2014年12月,秭归县人民医院手术治疗年龄超过65岁的老年腹股沟疝患者的资料。开放手术组患者的平均年龄72.9岁,腹腔镜组患者的平均年龄72.4岁。根据手术方法不同,分为开放手术组(75例)和腹腔镜组(33例)。对比二组患者的平均住院时间、平均手术时间、术后下次活动时间、术后疼痛持续时间、估计平均失血量、平均静脉输液量、术后30 d内的死亡率等情况,比较二组患者的术后并发症发生情况,并进行多元Logistic回归分析。结果二组患者平均住院时间、手术时间、术后下次活动时间以及估计平均失血量对比较,差异无统计学意义(P>0.05),腹腔镜组术后疼痛持续时间少于开放手术组,静脉输液量显著高于开放手术组,差异有统计学意义(P<0.05)。二组间围手术期并发症无统计学差异。多元回归模型分析显示良性前列腺增生,双侧修复或其它变量与住院时间无相关性。二组间均无死亡发生。结论与开放腹股沟疝修补术比较,腹腔镜腹股沟疝修补术可以安全、有效的治疗老年患者,没有增加发病率和死亡率。
Objective To compare the laparoscopic and conventional open inguinal hernia repair in the population over 65 years of age. Methods The medical data of 108 patients over 65 years of age who presented with inguinal hernia and underwent surgical treatment between July 2011 and December 2014 in Zigui District People＇s Hospital,were prospectively recorded. The patients were divided into open group and laparoscopic group according to the operation method. The mean hospital stay time,mean operation time,time to ambulate after surgery, postoperative pain duration, intraoperative blood loss, intraoperative intravenous fluid infusion,mortality in 30 days after surgery,and postoperative complications were compared with the two groups,and logistic regression models were used for analysis. Results There were no significant differences in operation time,postoperative hospitalization time,time to ambulant after surgery and intraoperative blood loss（ P 0. 05）. The laparoscopic group had a significantly higher mean volume of intraoperative intravenous fluid infusions,and a significantly lower postoperative pain duration（ P 0. 05）.Multivariate linear regression showed that benign prostate hypertrophy,bilateral hernia repair or other variables were not found to be related to prolonged hospital stay time. There was no mortality in both groups.Conclusion Similar to the outcome of open procedure,laparoscopic inguinal hernia repair can be safe and effective in the treatment of elderly patients without increase in morbidity and mortality.
出处
《中华疝和腹壁外科杂志（电子版）》
2015年第6期69-71,共3页
Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)
