自制双平片全腹股沟疝修补术与疝环充填式无张力疝修补术的对比研究

Comparative study of entire myopectineal orifice hernioplasty with mesh plug tension-free hernioplasty for inguinal hernia

目的:观察自制双平片全腹股沟肌耻骨孔无张力疝修补的效果。方法:90例腹股沟疝患者,随机分为2组。45例行自制双平片全腹股沟疝修补术(研究组),将1张自行裁剪的9cm×9cm的平片直视下放置于肌耻骨孔(myopectineal orifice)的腹膜前间隙,另1张6cm×9cm的平片放置于腹横筋膜、提睾肌之上,四周加以固定,封闭肌耻骨孔的缺损。另45例行疝环充填式无张力疝修补术(对照组)。结果:两组均随访3～4年,研究组患者无复发,无特殊并发症,术后疼痛分级和综合性价比均优于对照组(P<0.05)。结论:自制双平片全腹股沟疝修补术符合全腹股沟疝修补的工程力学要求,达到了无张力疝修补,手术操作简单,材料成本降低,术后效果优于疝环充填式无张力疝修补术。

Objective： To study the effect of entire myopectineal orifice hernioplasty with double patch. Methods： Ninety cases with inguinal hernia were randomly divided into two groups. Fourty-five cases were for the study group that entire myopectineal orifice hernioplasty with self-made double patch： a self-cutting 9 cm×9 cm patch in the preperitoneal space of myopectineal orifice and another 6 cm×9 cm patch on the transverse fascia and cremaster. The patch was fixed and the myopectineal orifice was closed. The other 45 cases were control group that mesh plug tension-free hernioplasty were applied. Result： No recurrence and special Commplications occurred in the study group after three to four-year follow-up; postoperative pain claSsification verbal rating scale were better than the control group （P〈0.05）. Conclusion： The entire myopectineal orifice hernioplasty with self-made double patch was consistent with the engineering mechanical requirements of entire inguinal hernia repair, and achieved a tension＇free hernia repair. Its procedure was simple and material cost was reduced.