腹腔镜腹股沟疝修补术与Lichtenstein术的对比研究  

A clinical control study of laparoscopic procedures vs Lichtenstein technique for inguinal hernia repair

作　　者：孙延军[1] 李健文[1] 郑民华[1] 蒋渝[1] 王明亮[1] 陆爱国[1] 胡伟国[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院普外科上海市微创外科临床医学中心,200025

出　　处：《中华疝和腹壁外科杂志（电子版）》2007年第1期21-24,共4页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

摘　　要：目的评价腹腔镜腹股沟疝修补术(LIHR)的临床安全性和有效性。方法对2003年1月至2006年1月所进行的251例LIHR和91例Lichtenstein术进行同期非随机对照研究,随访时间18～36个月。结果LIHR和Lichtenstein的手术时间差异无统计学意义(P>0.05);两组的术后住院天数分别为(2.9±1.2)d和(3.2±1.1 d)d(P=0.107),恢复非限制性活动天数分别为(4.0±1.3)d和(4.2±2.0 d)d(P=0.167),差异无统计学意义;术后应用镇痛剂人数分别为0和2.2%;两组的术后复发率分别为0.68%和0.93%(P=1.000);两组列前3位并发症均依次为血清肿、暂时性神经感觉异常和尿潴留,其中血清肿的发生率分别为5.5%和4.7%(P=0.764),暂时性神经感觉异常的发生率分别为1.4%和1.9%(P=0.659),尿潴留的发生率分别为2.4%和2.8%(P=0.730),差异均无统计学意义。LIHR组的住院总费用(7058.4±1033.7)元高于Lichtenstein组(4012.6±312.8)元,差异有统计学意义(P=0.000)。结论LIHR和Lichtenstein术都是安全有效的无张力修补方式,在临床上具有互补性,合理的选择术式可获得最佳的临床和卫生经济学效益。Objective To evaluate the clinical safety and efficiency of laparoscopic inguinal hernia repair （LIHR）. Methods A non-randomized concurrent control study was performed including 251 LIHR and 91 Lichtenstein repair during Jan. 2003 and Jan. 2006, the cases were followed-up for 18 - 36 months. Results There was no significant difference in operating time between LIHR and Lichtenstein procedures. The postoperative hospital stay were 2.9 ± 1.2 d vs 3.2 ± 1.1 d （ P =0. 107 ）, and the time of return to normal activity were 4.0 ＋ 1.3 d vs 4.2 ±2.0 d （P =0. 167） respectively in 2 groups. The require to analgesics were 0 and 2.2% in 2 groups. The recurrence rate of 2 groups were 0.68% and 0.93% respectively （P = 1. 000）. The serema, transient neurapraxia and urinary retention ranked as the most common morbidity, and there were no significant difference in 2 groups. The cost in hospital of LIHR group （7058.4 ± 1033.7 yuan） was significantly higher than that of Lichtenstein group （4012.6 ± 312yuan, P = 0. 000）. Conclusion LIHR and Lichtenstein are beth safe and efficient tension-free techniques for inguinal hernias repair, the correct choice of repair method can offer the best clinical and cost-effective results.

关 键 词：疝 腹股沟 外科手术 腹腔镜 

分 类 号：R656.2[医药卫生—外科学]