三种不同腹股沟疝手术修补方案的临床有效性及安全性分析  

Clinical effectiveness and safety analysis of three different surgical repairs for inguinal hernia

作　　者：王凡 WANG Fan(Department of Surgery,the Second People's Hospital of Nansha District,Guangzhou 511455,China)

机构地区：[1]广州市南沙区第二人民医院外科,511455

出　　处：《中国实用医药》2024年第9期56-58,共3页China Practical Medicine

摘　　要：目的 比较平片无张力疝修补术(Lichtenstein)、疝环充填式疝修补术(Rutkow)、腹膜前修补术(Kugel)三种修补方案治疗腹股沟疝的疗效及安全性。方法 60例成人腹股沟疝患者,根据修补方案的不同分为Lichtenstein组、Rutkow组、Kugel组,各20例。比较三组临床指标(手术时间、术后下床时间、住院时间)、术后早期并发症发生情况、术后不同时间疼痛程度及随访2年的术后复发率、异物感。结果 Lichtenstein组、Rutkow组、Kugel组手术时间分别为(65.2±10.3)、(58.6±9.5)、(72.1±11.2)min,术后下床时间分别为(12.8±3.1)、(10.4±2.6)、(14.2±3.5)h,住院时间分别为(5.6±1.2)、(4.9±1.0)、(6.2±1.4)d,三组比较有显著差异(P<0.05)。Kugel组术后早期并发症发生率5.00%略低于Lichtenstein组的10.00%和Rutkow组的10.00%,但并无显著差异(P>0.05)。术后1 d, Lichtenstein组、Rutkow组、Kugel组视觉模拟评分法(VAS)评分分别为(4.13±1.02)、(4.22±1.33)、(3.91±1.40)分,比较无显著差异(P>0.05)。术后1个月, Lichtenstein组、Kugel组VAS评分分别为(2.31±0.41)、(2.26±0.57)分,均低于Rutkow组的(3.16±0.92)分;术后6个月, Lichtenstein组、Kugel组VAS评分分别为(1.02±0.97)、(0.97±0.82)分,均低于Rutkow组的(1.91±1.55)分,有显著差异(P<0.05)。在术后2年的随访中,三组复发率比较,无显著差异(P>0.05);但Rutkow组的异物感占比60.00%明显高于Lichtenstein组的5.0%和Kugel组的10.0%,有显著差异(P<0.05)。结论 Lichtenstein、Rutkow、Kugel治疗腹股沟疝的疗效及并发症几乎接近,宜根据不同病例采用不同方案。Objective To compare the efficacy and safety of Lichtenstein tension-free hernia repair(Lichtenstein),mesh-plug hernia repair(Rutkow)and preperitoneal hernia repair(Kugel)for inguinal hernia.Methods 60 adult patients with inguinal hernia were divided into Lichtenstein group,Rutkow group,and Kugel group according to the different surgical repairs,with 20 cases in each group.The clinical indicators(operation time,postoperative ambulation time,hospitalization time),the occurrence of early postoperative complications,the pain level at different postoperative times,postoperative recurrence rate and foreign body sensation after 2 years of follow-up were compared among the three groups.Results The mean operation time of Lichtenstein group,Rutkow group,and Kugel group were(65.2±10.3),(58.6±9.5)and(72.1±11.2)min,the mean postoperative ambulation time were(12.8±3.1),(10.4±2.6)and(14.2±3.5)h,and the mean hospitalization time were(5.6±1.2),(4.9±1.0)and(6.2±1.4)d,there was a significant difference among the three groups(P<0.05).The incidence of early postoperative complications in Kugel group was 5.00%,which was slightly lower than that in Lichtenstein group(10.00%)and Rutkow group(10.00%),but there was no significant difference(P>0.05).1 day after surgery,VAS scores in Lichtenstein group,Rutkow group and Kugel group were(4.13±1.02),(4.22±1.33)and(3.91±1.40)points,and there was no significant difference(P>0.05).1 month after surgery,the visual analogue scale(VAS)scores in Lichtenstein group and Kugel group were(2.31±0.41)and(2.26±0.57)points,which were lower than Rutkow group's(3.16±0.92)points.6 months after surgery,VAS scores in Lichtenstein group and Kugel group were(1.02±0.97)and(0.97±0.82)points,which were significantly lower than Rutkow group's(1.91±1.55)points(P<0.05).After 2 years of follow-up,there was no significant difference in recurrence rate among the three groups(P>0.05);but the percentage of foreign body sensation(60.00%)in Rutkow group was significantly higher than that in Lichtenstein group

关 键 词：腹股沟疝手术 平片无张力疝修补术 疝环充填式疝修补术 腹膜前修补术 临床有效性 安全性 

分 类 号：R656.21[医药卫生—外科学]