Lichtenstein术与Rutkow术治疗老年腹股沟疝对患者术后慢性疼痛发生情况的影响观察

Effects of Lichtenstein and Rutkow in Treatment of Elderly Patients with Inguinal Hernia on Postoperative Chronic Pain

目的比较平片式无张力疝修补术(Lichtenstein术)和网塞充填式无张力疝修补术(Rutkow术)治疗老年腹股沟疝患者术后慢性疼痛发生情况及疗效。方法选取2017年3月—2018年10月在宁夏回族自治区吴忠市人民医院接受治疗的老年腹股沟疝患者88例,按照随机数字编号法分为对照组和观察组,每组44例。观察组采用Lichtenstein术,对照组采用Rutkow术,比较两组的治疗效果。结果观察组患者的手术时间、术后首次下床时间、住院时间、恢复正常活动时间均低于对照组,差异有统计学意义(P<0.05);观察组伤口感染、阴囊肿胀、伤口积血、尿潴留、术后发热的不良事件发生率为5.45%显著低于对照组18.18%,差异有统计学意义(P<0.05);两组患者术后疼痛情况均有所缓解,术后第3天、第7天、1个月的慢性疼痛视觉评分与术后第1天比较差异有统计学意义(P<0.05),观察组术后第1天、第3天、第7天、1个月的慢性疼痛视觉评分均低于对照组,差异有统计学意义(P<0.05)。结论Lichtenstein术比Rutkow术修复效果更好,术后恢复快、并发症少,慢性疼痛发生情况较少。

Objective To compare effects and curative effect of Lichtensteintension-free hernioplasty Lichtenstein and Rutkow tension-free hernioplasty(Rutkow)in treatment of elderly patients with inguinal hernia on postoperative chronic pain.Methods 88 elderly patients with inguinal hernia who were treated in the hospital from March 2017 to October 2018 were enrolled.They were divided into control group and observation group according to random numbering method,44 cases in each group.The observation group was treated with Lichtenstein,while control group was treated with Rutkow.The curative effect was compared between the two groups.Results The operation time,postoperative first leaving bed time,hospitalization time and time of returning to normal activity in observation group were shorter than those in control group(P<0.05).The incidence of adverse events such as wound infection,scrotumswelling,wound hematocele urinary retention and postoperative fever in observation group was significantly lower than that in control group(5.45%vs 18.18%)(P<0.05).Postoperative pain in both groupswas relieved.The differences in scores of chronic pain visual analogue scale(VAS)on 3rd day,7th day and 1st month after surgerywere statistically significant from those on 1st day after surgery(P<0.05).On the 1st day,3rd day,7th day and 1st month after surgery,scores of chronic pain VAS in observation group were lower than those in control group(P<0.05).Conclusion The repair effect of Lichtenstein is better than that of Rutkow,which is accompanied with quick postoperative recovery,few complications and less chronic pain.