平片式、疝环充填式和腹膜前疝修补治疗成人腹股沟疝的临床对比分析  

A comparative study of Lichtenstein,Rutkow and Kugel in treatment of adult inguinal hernia

作　　者：张伟元[1] ZHANG Weiyuan(Department of General Surgery,Changzhou Wujin People's Hospital ,Jiangsu Province, Changzhou 213000,China)

机构地区：[1]常州市武进人民医院普外科,江苏常州213000

出　　处：《临床外科杂志》2018年第12期922-924,共3页Journal of Clinical Surgery

摘　　要：目的探讨平片式、疝环充填式和腹膜前疝修补治疗成人腹股沟疝的效果和安全性。方法成人腹股沟疝病人155例。根据手术方式不同分为三组,平片组61例,采用平片式无张力疝修补,疝环充填组43例,采用疝环充填式修补,腹膜前组51例,采用腹膜前无张力疝修补。比较三组病人围手术期情况、术后并发症、术后疼痛程度、术后异物感和复发率。结果三组手术时间、下床活动时间、住院时间比较差异无统计学意义(P> 0. 05)。术后共发生尿潴留2例,阴囊水肿1例,切口感染1例,三组术后并发症总发生率比较差异无统计学意义(P> 0. 05)。疝环充填组术后1个月、3个月的VAS评分高于平片组和腹膜前组,差异有统计学意义(P <0. 05)。疝环充填组主诉有明显异物感8例(18. 60%),明显高于平片组和腹膜前组,差异有统计学意义(P <0. 05)。三组术后复发率比较差异无统计学意义(P> 0. 05)。结论平片式、疝环充填式和腹膜前疝修补治疗成人腹股沟疝的疗效相当,疝环充填式病人术后异物感和疼痛感较明显。平片式无张力疝修补术疗效确切,并发症少,复发率低,操作便捷,费用低。Objective To investigate the effect and safety of Lichtenstein,Rutkow and Kugel in treatment of adult inguinal hernia. Methods The clinical data of 155 adult inguinal hernia patients were retrospectively analyzed. All of the patients were divided into Lichtenstein group( n = 61),Rutkow group( n = 43) and Kugel group( n = 51),according to the different surgical methods. The perioperative period,postoperative complications,postoperative pain,postoperative foreign body sensation and recurrence rate between the three groups were compared. Results There was no significant difference in operation time,off-bed time and hospitalization time between the three groups( P > 0. 05). Postoperative urinary retention occurred in 2 cases,scrotal edema in 1 cases,incisional infection in 1 cases,and there was no significant difference in the total incidence of postoperative complications between the three groups( P > 0. 05). The VAS scores of Rutkow group were significantly higher than those in Lichtenstein group and Kugel group at1 month and 3 months after operation,and the differences were statistically significant( P < 0. 05). In Rutkow group,8 cases( 18. 60%) had obvious foreign body sensation,which was significantly higher than that in Lichtenstein group and Kugel group,and the difference was statistically significant( P < 0. 05). There was no significant difference in recurrence rate between the three groups( P > 0. 05). Conclusion Lichtenstein,Rutkow and Kugel have equal effect in treatment of adult inguinal hernia. The Rutkow group have obvious postoperative pain and postoperative foreign body sensation. Lichtenstein has curative effect in treatment of adult inguinal hernia,with fewer complications,low recurrence rate,convenient operation and low cost.

关 键 词：平片式无张力疝修补术 疝环充填式修补术 腹膜前无张力疝修补术 成人腹股沟疝 

分 类 号：R656.21[医药卫生—外科学]