4种成人腹股沟疝术式术后复发的临床分析  

Clinical Analysis of Postoperative Recurrence of Four Types of Adult Inguinal Hernia Surgical Approaches

作　　者：吴金成[1] 张思宇[1] 黄小蓉[1] WU Jincheng;ZHANG Siyu;HUANG Xiaorong(Department of General Surgery,The First Affliated Hospital of Xiamen University,Xiamen Fujian 361000,China)

机构地区：[1]厦门大学附属第一医院普外科,福建厦门361000

出　　处：《中国卫生标准管理》2018年第17期68-71,共4页China Health Standard Management

摘　　要：目的回顾性分析4种成人腹股沟疝术式术后复发患者的临床资料,总结可能导致复发的因素,为临床腹股沟疝手术治疗提供参考。方法对2006年1月—2010年3月我院收治的1 992例男性腹股沟疝患者随机入组行平片无张力疝修补术(Lichtenstein术)、开放充填式无张力疝修补术(Rotkow术)、开放腹膜前无张力修补术、腹腔镜下腹膜前无张力修补术(TEA术)。术后对所有患者随访8年,对各组患者术后复发情况进行临床分析。结果复发患者为66例,总复发率为3.31%,前述各组的复发数(复发率)分别为29(5.82%)、18(3.61%)、14(2.81%)、5(1.00%)。所有复发患者距离前一次手术后平均复发时间为(3.8±1.7)年,前述各组平均复发时间分别为(2.6±2.4)年、(3.1±1.6)年、(3.8±1.5)年、(5.6±2.2)年。各组真性复发率分别为65%、32%、56%、54%。复发患者中合并便秘、前列腺增生及吸烟的比例分别为23%、41%、46%,而未复发患者中前述比例分别为8%、21%、15%。结论腹腔镜腹股沟疝无张力修补术后复发率低,复发时间较晚,便秘、前列腺增生和吸烟是复发的重要因素,腹股沟疝手术前后需积极治疗相应的并发症,劝阻患者吸烟。Objective To analyze the postoperative recurrence data of patients received 4 kinds of different adult inguinal hernia surgery respectively, to summarize the factors that may lead to relapse, provide reference for clinical inguinal hernias operation cure. Methods From January 2006 to March 2010, 1 992 cases of male inpatients in our hospital with inguinal hernia were randomly allocated into 4 teams respectively accepted flat piece without tension hernia repair（Lichtenstein）, open type filling without tension hernia repair（Rotkow）, open before the peritoneum without tension repair, no tension laparoscopicbefore peritoneal repair（TEA）. All patients were followed up for 8 years after surgery, the postoperative recurrence was analyzed in each group. Results 66 patients with recurrence, overall recurrence rate was 3.31%, number of recurrence（CLT） in each group were 29（5.82%）、18（3.61%）、14（2.81%）、5（1.00%）respectively. The average recurrence time was（3.8±1.7） years, and the average recurrence time in each group were（2.6±2.4） years,（3.1±1.6） years,（3.8± 1.5） years,（5.6 ±2.2） years respectively. The true recurrence rate of each group were 65%, 32%, 56%, 54% respectively. The incidence rate of constipation, prostate hyperplasia and smoking in the patients with inguinal hernia recurrence were 23%, 41% and 46% respectively, and 8%, 21% and 15% respectively in the patients without inguinal hernia recurrence. Conclusion The postoperative recurrence rate is lower in the patients who accepted laparoscopic inguinal hernias repair, and its recurrence time is later, the merger of constipation, prostate hyperplasia and smoking is important factors that easy to cause recurrence afteringuinal hernia surgery, it needs active treatment before and after surgery and discourage smoking is needed.

关 键 词：复发率 复发时间 真性复发 手术方式 成人腹股沟疝 合并症 

分 类 号：R619[医药卫生—外科学]