TAPP和Lichtenstein術(shù)治療成人嵌頓性腹股溝疝的效果比較

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Comparison of TAPP and Lichtenstein in the Treatment of Adult Incarcerated Inguinal Hernia/ DANG Bin，HUI Xiaojun. //Medical Innovation of China， 2025， 22（10）： 023-027

[Abstract]Objective： To compare the clinical effcts of transabdominal preperitoneal approach （TAPP） andtensionfreeherniarepair（Lichtenstein）inthetreatmentof adultincarcerated inguinalhernia.Method：From January 2019 to December 2023，72 adult patients with incarcerated inguinalhernia were diagnosed and treated in the General Surgery Department of Changan District Hospital of Xi'an City.According to the random number table method， they were divided into Lichtenstein group （Lichtenstein treatment， 36 cases） and TAPP group（TAPP treatment， 36cases）.Perioperative indexes， visual analogue scale （VAS）scores，complication rate，inflammatory stress response indexes [adrenocorticotropic hormone （ACTH）， noradrenaline （NE）， C reactive protein （CRP）， interleukin-6 （IL-6）] and recurrence rate were compared between the two groups. Result： The operative time of TAPPgroup was longer than that of Lichtenstein group，the intraoperative blood lossVAS scores at 2，12and 24h after surgery，and the incidence of complications were lower than those of Lichtenstein group，and thefirst time of geting out ofbedand firsttime ofeating aftersurgery wereearlierthan those of Lichtensteingroup，the length of hospital stay was shorter than that of Lichtenstein group （ P <0.05）. 24 h before operation， there were no differences in ACTH， NE， CRP and IL-6 between the two groups （ P> 0.05）. 24 h after operation， ACTH， NE， CRP and IL-6 increased in both groups， but those of TAPP group were lower than those of Lichtenstein group （ P <0.05）. The recurrence rate at 6 months after operation in TAPP group was lower than that in Lichtenstein group （ P <0.05）.

Conclusion： Compared with Lichtenstein， TAPPhas the advantages of lesspain，lessbloodloss， low complications， less inflammation and stress reaction，rapid postoperative recovery，and recurrence rate in the treatment of adult incarcerated inguinal hernia.

[Key words] Adult incarcerated inguinal hernia Transabdominal preperitoneal approach Lichtenstein

First-author's address： Department of General Surgery， Chang'an District Hospital of Xi'an City， 'an 710100， China

doi：10.3969/j.issn.1674-4985.2025.10.006

嵌頓性腹股溝疝是一種類型比較特殊的腹股溝疝，通常是由于腹腔內(nèi)壓增大、腹壁組織薄弱，腹股溝疝內(nèi)容物突入皮下而難以正常回納所致，臨床癥狀多表現(xiàn)為腹肌緊張、腸鳴音高亢、腹部劇烈疼痛，若耽誤診治，易引起腹腔感染、腸梗阻、腸管缺血壞死等嚴(yán)重不良后果，危及患者身心健康和生命安全2。（剩余6189字）