TAPP和Lichtenstein术治疗成人嵌顿性腹股沟疝的效果比较

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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

嵌顿性腹股沟疝是一种类型比较特殊的腹股沟疝，通常是由于腹腔内压增大、腹壁组织薄弱，腹股沟疝内容物突入皮下而难以正常回纳所致，临床症状多表现为腹肌紧张、肠鸣音高亢、腹部剧烈疼痛，若耽误诊治，易引起腹腔感染、肠梗阻、肠管缺血坏死等严重不良后果，危及患者身心健康和生命安全2。（剩余6189字）