疝环充填与下腹正中切口腹膜前间隙无张力疝修补术的对比  

Comparison between tension-free inguinal hernia repair with mesh plug and tension-free repair of preperitoneal space with middle abdominal incision

作　　者：梁峰[1] 李飞[1] 聂双发[2] 高晓斌[1] 

机构地区：[1]河北北方学院附属第一医院肝胆外科,河北省张家口市075000 [2]河北北方学院附属第一医院胃肠外科,河北省张家口市075000

出　　处：《实用医学杂志》2017年第21期3597-3601,共5页The Journal of Practical Medicine

基　　金：河北省医学科学研究重点课题计划(编号:20160357)075000

摘　　要：目的探讨疝环充填式无张力疝修补术(Rutkow术)和下腹正中切口腹膜前间隙无张力疝修补术(开放TEP术)对患者术后并发症及生活质量的影响。方法回顾性分析收治的腹股沟疝患者122例,62例行开放TEP术(观察组),60例行Rutkow术(对照组)。比较两组手术基本情况,术后并发症发生情况,治疗前后生活质量评分。结果所有患者术后均未发生膀胱和输精管损伤、感染、切口血肿等,术后随访均无复发、补片排异、感染、睾丸萎缩等;观察组伤口疼痛持续时间显著低于对照组(P<0.01),其他手术指标对比差异无显著性(P>0.05);观察组术后并发症发生率为11.29%,显著低于对照组(P<0.01);两组治疗后PCS、MCS评分均较治疗前显著上升(P<0.01),但观察组升高更显著(P<0.01)。结论开放TEP术较Rutkow术治疗腹股沟疝具有术后疼痛轻、并发症少等优点,更能提高生活质量。Objective To conduct a comparative study on postoperative complications and patients′ quali-ty of life between tension-free inguinal hernia repair with mesh plug(Rutkow operation)and tension-free repair ofpreperitoneal space with middle incision of lower abdomen(Open TEP operation). Methods A retrospective anal-ysis of 122 cases of inguinal hernia was conducted. And 62 cases of Open TEP operation were concluded into obser-vation group and 60 cases of Rutkow operationinto control group. The basic information of the surgery,postopera-tive complications and the score of quality of life before and after treatment were compared between 2 groups.Results No bladder injury,ductus deferens damage,infections or hematoma on incisions were found after opera-tion and no relapse,patch rejection,infections or atrophia testiculi were seen during the follow-up. The incisionpain of observation group lasted shorter than that of control group(P < 0.01),while other operational indexes showno great difference(P > 0.05). The incidence of postoperative complications of observation group was 11.29%,much lower than that of control group(P < 0.01). Both PCS and MCS scores of 2 groups after treatment increasedobviously as compared with those before treatment(P < 0.01),but the rise in observation group were more signifi-cant(P < 0.01). Conclusion Less postoperative pain and complications,and better life quality are found in thetreatment of inguinal hernia with open TEP operation outperforms Rutkow operation.tension-free inguinal hernia repair with mesh plugpreperitoneal spaceinguinal hernia

关 键 词：疝环充填式无张力疝修补术 腹膜前间隙 腹股沟疝 术后并发症 生活质量 

分 类 号：R656.2[医药卫生—外科学]