前入路腹膜前修补与疝环充填式修补术治疗腹股沟疝的对比研究  

The comparative study of preperitoal anterior apprneoach repair and mesh plug hernioplasty

作　　者：郑晶晶[1] 胡平[1] 章平禄[1] 邵初晓[1] 

机构地区：[1]浙江省丽水市中心医院疝与腹壁外科中心,323000

出　　处：《中华全科医学》2014年第3期368-370,F0003,共4页Chinese Journal of General Practice

摘　　要：目的比较前入路腹膜前修补术与疝环充填式修补术的术后并发症、疗效。方法回顾性研究453例(489侧)腹股沟疝患者,分为腹膜前组和网塞修补组。腹膜前修补组230例(243侧),使用超普补片行前入路腹膜前修补术。网塞修补组223例(246侧),采用网塞补片行疝环充填式修补术,2组性别、年龄、疝分型构成、合并症比较差异无统计学意义。比较2组的平均手术时间与术后的平均住院时间、尿潴留、疼痛、精索阴囊肿胀、积液、异物感发生率和复发率。对所有患者进行术后随访,腹膜前修补组随访18.1个月,网塞修补组平均随访17.9个月。结果 2组平均手术时间、平均住院时间、术后尿潴留、术后疼痛、精索阴囊肿胀、积液发生率比较差异无统计学意义(P>0.05)。2组均未见手术区域深部感染、补片异物反应、睾丸并发症、性功能异常等。腹膜前修补组异物感发生率、术后复发率较网塞修补组低,差异有统计学意义(P<0.05)。结论前入路腹膜前修补术较疝环充填修补术的异物感发生率、复发率低,是腹股沟疝较理想的手术方式。Objective To compare with the operation effect of preperitoneal hernioplasty with mesh plug hernioplasty. Methods Retrospective study of 453 patients （489 sides） with inguinal hernia was conducted. Preperitoneal group （230 cases ,243 sides） was treated super patch in preperitoal anterior apprneoach in tension-free repair. 223 cases（246 sides） im mesh plug group were used the mesh plug repair. The two groups had no statistically significant difference in gender, age, hernia classification and complications difference. The average operation time, average hospitalization time, retention of urine, pain, swelling spermatic cord and scrotum effusion, foreign body sensation, the incidence and recurrence rate of the two groups were compared. Results Two groups were followed up, preperitoneal anterior apprneoaeh repair group were followed up for an average of 18.1 months, the mesh plug repair group were followed up for an average of 17.9 months. Two groups of average operation time, hospitalization time, complications and spermatic cord hydrocele edema rate showed no significant difference（P 〉 0.05 ）. The two groups were no operation region of deep infection,foreign body reaction of patch, sexual dysfunction and other complications of testis. Preperitoneal repair of postoperative recurrence rate,foreign body sensation occurred with mesh plug was low, the difference was significant difference （P 〈 0. 05 ）. Conclusion Preperitoal anterior apprneoach repair can reduce the incidence of foreign body sensation with low recurrence rate, which was an ideal operation for inguinal hernia.

关 键 词：腹股沟疝 疝修补术 腹膜前间隙 无张力 

分 类 号：R656.2[医药卫生—外科学]