横切口改良Kugel手术用于老年男性腹股沟疝的临床评价  

Evaluation of clinical efficacy of modified Kugel repair with transverse abdominal incision in treatment of elderly male patients with inguinal hernia

作　　者：周如建[1] 吕会增[1] 叶小勇[1] 张帆[1] 刘纪明[1] 张利国 袁晓鹏[1] Zhou Rujian;Lyu Huizeng;Ye Xiaoyong;Zhang Fan;Liu Jiming;Zhang Liguo;Yuan Xiaopeng(Department of General Surgery,the Fifth Affiliated Hospital of Guangzhou Medical University,Guangzhou 510700,China)

机构地区：[1]广州医科大学附属第五医院普通外科,广州510700

出　　处：《新医学》2018年第7期525-529,共5页Journal of New Medicine

基　　金：广东省医学科学技术研究基金(A2015404)

摘　　要：目的评价横切口改良Kugel手术在老年男性腹股沟疝中的临床效果。方法纳入298例老年男性腹股沟疝患者,分别采用横切口改良Kugel手术治疗(A组,150例)和改良Lichtenstein手术治疗(B组,148例),前瞻性对比分析2组的手术时间、术后疼痛程度、术后下床时间、术后住院时间、术后并发症(切口感染、尿潴留、阴囊血肿或水肿、慢性疼痛、复发)等指标。结果 2组手术均顺利完成,患者均无发生围手术期严重并发症。与B组患者相比,A组患者的术后12 h下床者和24 h出院者比例较高,术后12 h应用镇痛药物者比例较低,术后慢性疼痛和总的并发症发生率亦较低(P均<0.05)。结论横切口改良Kugel手术用于老年腹股沟疝具有安全、可靠、痛苦更少、恢复更快的特点,可作为老年男性腹股沟疝患者首选术式。Objective To prospectively assess the clinical efficacy of modified Kugel tension-free repair with transverse abdominal incision in the treatment of elderly male patients diagnosed with inguinal hernia.Methods A total of 298 elderly male patients with inguinal hernia were recruited and randomly divided into two groups. In group A,patients received modified Kugel tension-free repair（ n = 150）. In group B,patients underwent modified Lichtenstein repair（ n = 148）. The operative time,degree of postoperative pain,postoperative off-bed time,length of postoperative hospital stay,postoperative complications（ incisional infection,urinary retention,scrotal hematoma or edema,chronic pain,recurrence rate） were statistically compared between two groups. Results In both groups,all operations were successfully completed. No severe perioperative complications occurred. Compared with group B,the percentage of off-bed at postoperative 12 h and hospital discharge at postoperative 24 h was significantly higher,the proportion of patients receiving analgesic drugs at postoperative 12 h was considerably lower and the incidence of postoperative chronic pain and the total incidence of postoperative complications was significantly lower in group A（ all P〈0. 05）. Conclusions Modified Kugel tension-free repair with transverse abdominal incision is a safe and reliable approach in treating elderly male patients with inguinal hernia,which mitigates postoperative pain and accelerates postoperative recovery,and serves as an optimal technique for elderly male individuals with inguinal hernia.

关 键 词：疝 腹股沟 疝修补术 老年人 并发症 

分 类 号：R656.21[医药卫生—外科学]