下腹正中切口腹膜前无张力疝修补术与疝环充填式疝修补术治疗双侧腹股沟疝的对比研究  

Comparative analysis of preperitoneal inguinal hernia repair via lower abdominal median incision and mesh-plug hernia repair in bilateral inguinal hernias

作　　者：陶平[1] 吴向阳[1] 张磊[1] 

机构地区：[1]南京医科大学附属南京医院普外科,210006

出　　处：《中华疝和腹壁外科杂志（电子版）》2016年第6期417-420,共4页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

摘　　要：目的 比较下腹正中切口腹膜前无张力疝修补术与疝环充填式疝修补术治疗成人双侧腹股沟疝的效果。方法 回顾性分析2008年1月至2015年6月,南京医科大学附属南京医院普外科收治双侧腹股沟疝64例患者临床资料,根据手术方式分为2组,前入路组34例,下腹正中切口组30例。比较2组的手术时间、术后疼痛程度与出院后手术区域疼痛的情况、住院时间、住院费用、局部血清肿、切口裂开。结果 2组患者均顺利完成手术,下腹正中切口组手术时间明显短于前入路组,差异有统计学意义（t=15.382,P〈0.05）。下腹正中切口组术后疼痛例数与术后疼痛时间明显少于前入路组,差异有统计学意义（χ2=15.47、11.97,P〈0.05）。2组住院时间、住院费用、局部血清肿与切口裂开发生率的比较差异无统计学意义（t=1.091、0.472,χ2=0.038、0.033,P〉0.05）。术后随访6-12个月,平均8.6个月,2组均无疝复发,补片感染或排异,睾丸萎缩等并发症。结论 对于双侧腹股沟疝患者,下腹正中切口腹膜前无张力疝修补术比疝环充填式疝修补术能明显缩短手术时间,减轻术后疼痛,值得基层医院推广。Objective To compare the curative effect of preperitoneal inguinal hernia repair via lower abdominal median incision and mesh-plug hernia repair in bilateral inguinal hernias. Methods The clinical data of 64 patients in Nanjing Hospital from January 2008 to June 2015 were analyzed retrospectively. The 64 patients with bilateral inguinal hernia were divided into two groups according to the operation performed： group-l, in which 34 patients received mesh-plug hernia repair; group-2, in which 30 patients received preperitoneal inguinal hernia repair via lower abdominal midline incision. The two groups were compared with operation time, postoperative pain score and time of post- discharge pain in operation area, hospitalization time, hospital cost,seroma, incision dehiscence. Results Operations were sucessftdly made in all the patients. The operation time was significantly longer in group 1 than that in group 2 （ t = 15. 382, P 〈 0. 05 ）. The postoperative pain score and the time of post-discharge pain were significantly higher in group 1 than those in group 2 （X^2 = 15. 47,11. 97; P 〈 0. 05）. There were no significantly differences between two groups in hospitalization time, hospital cost, incidence of seroma and incidence of incision dehiscence （t = 1. 091, 0.472; X^2 = 0. 038, 0. 033; P 〉 0. 05）. All the 64 cases were followed up for 6-12 months （mean, 8.6 months）. No severe postoperative complication was encountered in both groups, such as recurrence, mesh infection or testicles atrophy. Conclusion Preperitoneal inguinal hernia repair via lower abdominal median incision is superior to mesh-plug hernia repair in operation time, postoperative pain in bilateral inguinal hernias. It is worthy of promotion in primary hospitals.

关 键 词：疝 腹股沟 疝修补术 腹膜 

分 类 号：R656.21[医药卫生—外科学]