腹股沟疝无张力修补术中并发症的预防501例分析

The prevention of complications in tension-free hernioplasty of 501 inguinal hernia cases

目的目的探讨腹膜前修复对防止疝复发等并发症的作用。方法从2007年1月至2009年12月,共501例腹股沟疝患者行无张力修补术,其中232例采用疝环充填法术式,269例采用腹膜前修补术式。观察随访患者术中、术后并发症及复发率。结果 501例患者的术后随访资料显示,两种术式在手术时间、术中并发症(出血、血管神经损伤、膀胱损伤)及术后并发症(阴囊积液、切口感染)上无明显差异(P>0.05)。但在术后异物感和慢性疼痛、复发方面,腹膜前组比疝环充填组明显减少,有显著性差异(P<0.01)。结论腹膜前耻骨肌孔的修复,构成完整腹股沟管后壁,能有效预防疝复发,可减轻术后局部异物感和慢性疼痛。

Objective To study the function of preperitoneal repair to prevent complications in inguinal hernia tension-free hernioplasty.Methods From Jan.2007 to Dec.2009,altogether 501 patients with inguinal hernia were treated with tension-free hernioplasty,among which 232 patients taken mesh plug repair,while 269 others taken preperitoneal repair.Complications in operation and after operation and recurrence rate were observed.Results There were no obvious differences between the two groups in operation time,complications in operation （hemorrhage,blood vessel neurotrosis,urinary bladder damage） and postoperative complications （scrotal hydrocele and incisional infection） （P0.05）,but patients taken preperitoneal repair suffered less foreign body sensation or chronic pain and recrudescence than those taken mesh plug repair （P0.01）.Conclusions Myopectineal orifice repair effec-tively prevent hernia recrudescence,and may reduce postoperative foreign body sensation or chronic pain.