【摘要】 目的 分析全腹膜外Sublay(totally extraperitoneal sublay, TES)与腹腔镜下腹腔内补片置入术(intraperitoneal onlay mesh, IPOM)在腹壁切口疝术中、术后的相关指标。方法 回顾性分析内蒙古科技大学包头医学院第一附属医院2018年1月到2021年11月腹壁切口疝患者60例，其中30例行TES手术，30例行IPOM手术。观察两组患者术中及术后相关指标。结果 两组病人性别、年龄、BMI、吸烟、合并基础疾病、腹壁切口疝部位等一般资料差异无统计学意义(P>0.05)。TES组平均手术时间高于IPOM组，经过比较，P<0.05差异有统计学意义；两组平均切口疝缺损大小、平均术中出血量经过比较，差异无统计学意义(P>0.05)。TES组术后24 h和3 d疼痛VAS评分、住院花费均低于IPOM组，P<0.05差异有统计学意义；两组术后住院时间相比，P>0.05差异无统计学意义。TES组感染、肠梗阻、肠管损伤、复发与IPOM组相比，P>0.05差异无统计学意义。两组慢性疼痛例数相比，P<0.05差异有统计学意义。结论 TES与IPOM手术对于修补腹壁切口疝同样安全有效，TES具有住院费用少、术后疼痛率低的优点。更多还原

【Abstract】 Objective To analyze the relevant indicators of(totally extraperitoneal sublay, TES)and(intraperitoneal onlay mesh, IPOM) during and after abdominal wall incision hernia.Methods 60 patients with abdominal wall incision hernia of the First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology were retrospective and analyzed from January 2018 to November 2021, including 30 TES procedures and 30 IPOM procedures.Intraoperative and postoperative relevant indicators in both patient groups were observed.Results There was no statistical difference between the IPOM group in TES and IPOM in patient gender, age, BMI, smoking, combined underlying disease, and abdominal incision hernia site(P>0.05).The mean surgical time was higher in the TES group than in the IPOM group, and after comparing, P<0.05 showed a statistically significant difference.The mean incision hernia defect size and mean intraoperative bleeding in between TES group and IPOM group were P>0.05, and the difference was not significant.The TES pain VAS score at 24 hours and 3 days were lower than in the IPOM group, with P<0.05,and a statistically significant difference.In the TES group, P>0.05 in the T E S and IPOM groups.Infection, intestinal obstruction, intestinal tube injury, and recurrence in the TES group showed no P>0.05 difference compared with the IPOM group.The difference was statistically significant compared with the number of chronic pain cases, with P<0.05 in the TES and IPOM groups.Conclusion TES and IPOM are equally safe and effective for repairing abdominal wall incision hernia. TES has the advantages of less hospital cost and low postoperative pain rate.更多还原