疝环充填式无张力疝修补术与完全腹膜外疝修补术治疗腹股沟疝临床疗效评价  

Comparing the clinical outcomes of Rutkow procedure and totally extraperitoneal hernioplasty repair in the treatment of inguinal hernia

作　　者：张国伟[1] 颜松龄[1] 周立新[1] 肖春林[1] 何力[1] 张贤文[1] 王茂林[1] 孙颖[1] 

机构地区：[1]厦门市第二医院普通外科,361021

出　　处：《中国医师进修杂志》2013年第35期14-17,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的比较疝环充填式无张力疝修补术（Rutkow术）与完全腹膜外疝修补术（TEP）治疗腹股沟疝的临床疗效。方法选择腹股沟疝患者353例，其中采用Rutkow术治疗182例（Rutkow术组），采用TEP治疗171例（TEP组）。比较两组手术时间，总出血量，术后第1、3天疼痛视觉模拟评分（VAS），近期并发症发生率，住院时间，住院总费用，恢复正常体力活动时间，疝再发率等指标。结果与Rutkow术组比较，TEP组术后第3天VAS低[（2．6±1.4）分比（3．1±1．5）分]、住院时间短[（3．2±2．4）d比（4．3±2．7）d]、恢复正常体力活动时间快[（23．3±17．8）d比（31．0±15．9）d]、术后疝再发率低[1．8％（3／171）比6．6％（12／182）]，但手术时间长[（45．6±36．1）rain比（35．2±20．5）min]、总出血量多[（27．7±20．4）ml比（15．8±10．7）ml]、住院总费用高[（9029．5±683．4）元比（6782．7±1076．3）元]，差异均有统计学意义（P〈0．01或〈0．05）；两组术后第1天VAS、近期并发症发生率比较差异无统计学意义（P〉0．05）。结论与Rutkow术比较，TEP治疗腹股沟疝具有术后疼痛轻、住院时间短、恢复正常体力活动时间快、术后疝再发率低等优势，值得推广。Objective To compare the clinical outcome of Rutkow procedure and totally extraperitoneal hernioplasty （TEP） for inguinal hernia. Methods Three hundred and fifty-three patients with inguinal hernia were divided into 2 groups according to the operation method： 182 cases underwent Rutkow procedure （Rutkow procedure group ） and 171 cases underwent TEP （TEP group ）. Operative time, overall blood loss, visual analogue score （VAS） on postoperative day 1 and day 3,rate of short-term complications,length of hospital stay,total cost,time to full recovery and hernia recurrence rate were compared between the 2 groups. Results TEP group had significantly lower VAS on postoperative day 3 [ （2.6 ± 1.4 ） scores vs. （3.1 ± 1.5 ） scores ], shorter length of hospital stay [ （3.2 ± 2.4 ） d vs. （4.3 ± 2.7 ） d ] and time to full recovery [ （ 23.3 ± 17.8 ） d vs. （ 31.0 ± 15.9 ） d ], lower hernia recurrence rate [ 1.8% （ 3/171 ） vs. 6.6%（12/182） ] ,but had longer operative time [ （45.6 ± 36.1 ） min vs. （35.2 ± 20.5 ） mini ,more overall blood loss [ （27.7 ± 20.4） ml vs. （ 15.8 ± 10.7 ） ml] ,higher total cost [ （9029.5 ± 683.4） yuan vs. （6782.7 ± 1076.3 ） yuan ], there were statistical differences between the 2 groups （P 〈 0.01 or 〈 0.05 ）. There were no statistical differences in VAS on postoperative day 1 and rate of short-term complications between the 2 groups （P 〉 0.05）. Conclusion TEP is recommendable because of the advantages of less postoperative pain, shorter length of hospital stay, faster to full recovery and lower recurrence rate, and it is worth to utilize in clinic.

关 键 词：疝 腹股沟 疝环充填式无张力疝修补术 完全腹膜外疝修补术 

分 类 号：R656.2[医药卫生—外科学]