疝环填充与Lichtenstein手术对老年腹股沟疝的疗效

Effect of hernia ring filling surgery versus Lichtenstein surgery in elderly patients with inguinal hernia

目的探讨疝环填充手术与Lichtenstein手术对老年腹股沟疝患者的治疗效果。方法回顾性分析2019年12月至2021年12月在颍上县人民医院普外科接受腹股沟疝手术治疗的老年患者106例的资料。依据手术方法分为对照组(53例,采用疝环填充术式)和观察组(53例,采用Lichtenstein术式)。比较2组的手术情况相关指标、疼痛情况指标(视觉模拟评分法评估术后24、72 h及1个月的疼痛严重程度)、术后并发症指标(切口感染、阴囊水肿、伤口血肿、肺部感染、尿潴留、睾丸炎、急性疼痛、慢性疼痛等)。比较2组术前及出院时的生活质量(SF-36量表)。结果2组的手术耗时、失血量、术后下床活动时间、总住院时间比较,差异均无统计学意义(P>0.05)。观察组术后24、72 h的疼痛评分均低于对照组(P<0.05),2组术后1个月的疼痛评分比较,差异无统计学意义(P>0.05)。2组术后各类并发症发生情况比较,差异无统计学意义(P>0.05)。2组术前SF-36评分差异无统计学意义(P>0.05);出院时,2组SF-36评分均明显增加(P<0.05),观察组评分高于对照组(P<0.05)。结论在老年腹股沟疝开放式手术治疗中,疝环填充与Lichtenstein术式均可以取得良好的治疗效果及安全性,Lichtenstein术式更有利于改善患者术后短期内的疼痛程度及生活质量。

Objective To explore the effect of hernia ring filling surgery and Lichtenstein surgery in the treatment of elderly patients with inguinal hernia.Methods Data of 106 elderly patients who underwent inguinal hernia surgery in the Department of general surgery of Yingshang County People's Hospital from December 2019 to December 2021 were analyzed retrospectively.According to the surgical methods,53 elderly patients with hernia ring filling were divided into control group and 53 elderly patients with Lichtenstein operation were divided into observation group.The operation related indicators,pain indicators(pain severity at 24 hours,72 hours,and 1 month after operation.Visual analogue scale),and postoperative complications indicators(incision infection,scrotal edema,wound hematoma,pulmonary infection,urinary retention,orchitis,acute pain and chronic pain)were compared between the two groups.The quality of life of the two groups before operation and at discharge(SF-36 scale)were compared.Results There was no significant difference in operation time,blood loss,postoperative ambulation time and total hospital stay between the two groups(P>0.05).The pain scores of the observation group at 24 hours and 72 hours after operation were lower than those in the control group(P<0.05).There was no significant difference in pain scores between the two groups at one month after operation(P>0.05).There was no significant difference in postoperative complications between the two groups(P>0.05).There was no significant difference in SF-36 scores between the two groups before operation(P>0.05).At discharge,SF-36 scores in both groups increased significantly(P<0.05).The SF-36 score in the observation group at discharge was higher than that in the control group(P<0.05).Conclusion In the open surgical treatment of elderly patients with inguinal hernia,hernia ring filling and Lichtenstein operation can both achieve good therapeutic effects and safety.Lichtenstein operation is more conducive to improving the short-term postoperative pain and quality of life of patients.