疝环充填式无张力疝修补术治疗滑疝

Mesh plug tension-free herniorrhaphy for treatment of sliding hernia

目的分析滑疝的特点和评价传统疝修补术与疝环充填式无张力疝修补术对滑疝治疗的效果。方法回顾性分析1 4年间收治的4 2 6例腹股沟疝中2 3例滑疝患者的临床资料,2 3例中用传统疝修补术1 0例,疝环充填式无张力疝修补术1 3例,术后随访1至3年,对两种术式的手术时间,术后镇痛例数,术后并发症、术后不适感和术后复发率等指标进行比较。结果传统疝修补术组与疝环充填组手术时间,住院时间无统计学差异(P>0.0 5),术后镇痛剂使用率分别为6 0.0%(6/1 0)和7.6%(1/1 3),术后并发症发生率分别为3 0.0%(3/1 0)和7.6%(1/1 3),术后不适感分别为5 0.0%(5/1 0)和7.6%(1/1 3),术后平均恢复工作时间分别为5 4 d和3 2 d,术后复发率分别为4 0%(4/1 0)和0%(P<0.0 5)。结论与传统疝修补术相比较,疝环充填式无张力疝修补术应用于滑疝的治疗具有手术操作简单,术后并发症和不适感较少,复发率低等。

Objective To analyze the characteristics of sliding hernia and evaluate the therapeutic effects of traditional herniorrhaphy and mesh plug tension-free herniorrhaphy for sliding hernia. Methods The clinical data of twenty three cases with sliding hernia, among 426 cases of inguinal hernia, treated in our hospital over a period of 14 years, were analyzed retrospectively. Traditional herniorrhaphy was performed in 10 cases and mesh plug herniorrhaphy in 13 cases. All of the patients were followed up for 1 to 3 years. The operative time, length of hospital stay, postoperative analgesic use, complications, and discomfort and recurrence rate were analyzed and compared in the 2 group. Results There was no significant difference in the operative time and length of hospital stay between the 2 group. The use of postoperative analgesic, postoperative complications, postoperative discomfort and recurrent rate in traditional and mesh plsg tension- free herniorrhaphy was 60% （6/10） and 7.6% （1/13）, 30.0% （3/10） and 7.6% （1/13） and 50% （ 5 / 10 ） and 7.6 % （ 1 / 13 ） , respectively ; while postoperative time for return to work was 54 d and 32 d, respectively, and the recurrence rate was 40% （4/10） and 0%, respectively, （ P 〈 0. 05 ）. Coaclusions Compared with traditional herniorrhaphy, mesh plug tension-free herniorrhaphy for sliding hernia has advantages, such as simple, less trauma, less postoperative discomfort, and lower recurrence rate, so, it is suitable for treatment of patient with sliding hernia.