摘要目的 探讨腹腔镜下完全腹膜外疝修补术后术区冰袋冷敷对患者术区疼痛、积液的影响.方法 回顾性分析2017年1月至2018年1月山西医科大学第一医院普外科收治的腹股沟斜疝患者58例的临床资料.均于全身麻醉下行腹腔镜下完全腹膜外腹股沟斜疝修补术.根据入院日期的单、双号将58例患者分为观察组和对照组,观察组32例术后术区压自制冰袋,对照组26例术后术区放置常温盐水袋.用数字评分法对患者疼痛程度进行评分,分析术后离床时间、术后出院时间、术区积液率、疝复发率.结果 观察组平卧位静息时疼痛评分、下地活动时疼痛评分、术区积液例数均优于对照组[(2.11 ±0.97)分比(2.45 ± 1.21)分,(2.63 ±1.89)分比(2.76 ±1.95)分,0 例比2 例],差异均有统计学意义( t＝2.745、4.189,χ2 ＝1.15,均P＜0.05);观察组与对照组术后离床时间、术后出院时间[(19.16 ±9.22) h比(19.76 ±10.52) h, (34.85 ±7.43)h比(37.56 ±8.91)h],差异均无统计学意义(t＝1.790、0.834,均P＞0.05).结论 腹腔镜下完全腹膜外疝修补术后术区冰袋冷敷,可以达到缓解术区疼痛,减少术区积液的效果.

abstractsObjective To evaluate the effects of total extraperitonal herniorrhaphy on pain and effusion in patients with surgical area.Methods The clinical data of 58 cases of inguinal hernia admitted to the First Hospital of Shanxi Medical University from January 2017 to January 2018 were retrospectively analyzed.Complete extraperitoneal inguinal oblique hernia repair was performed under laparoscopy under general anesthesia .The patients were divided into two groups by the single or double of admission date number.The observation group(A group,32 cases) received post－operative intraoperative pressure homemade ice bags ,the control group ( B group,26 patients) was placed in normal temperature saline bag after operation.The degree of pain in patients was evaluated by numerical scoring method. The time of exit,discharge,accumulation rate and recurrence rate of hernia were analyzed.Results The differences in pain score,pain score during floor movement ,and regional efflux rate between A group and B group were statistically significant[(2.11 ±0.97)points vs.(2.45 ±1.21) points,(2.63 ±1.89) points vs.(2.76 ±1.95) points,0 case vs.2 cases,t ＝2.745,4.189;χ2 ＝1.15,all P＜0.05].The time of discharge from hospital and discharge after surgery in A group and B group were (19.16 ±9.22) h vs.(19.76 ±10.52) h,(34.85 ±7.43) h vs.(37.56 ± 8.91) h, the difference was not statistically significant ( t ＝1.790, 0.834, all P ＞0.05 ).Conclusion After laparoscopic repair of total extraperitonal herniorrhaphy ,the area ice pack can achieve the purpose of relieving pain in the surgical area and reducing the accumulation of fluid in the surgical area .