Modified Kugel术与Lichtenstein术修补成人原发性腹股沟疝的对比研究

Comparison of Modified Kugel herniorrhaphy with Lichtenstein herniorrhaphy in the treatment of primary adult inguinal hernias

目的对比Modified Kugel(M-K)术和Lichtenstein术修补成人原发性腹股沟疝的手术疗效。方法采用随机双盲对照研究方法,145例患者分为2组,分别采用M-K术和Lichtenstein术,比较2组平均手术时间、住院天数、恢复正常活动时间、治疗费用以及近、远期并发症等指标。结果 M-K组和Lichtenstein组平均手术时间[(38±5)min vs.(42±7)min]、尿潴留发生率(2.78%vs.2.74%)、平均住院天数[(3.85±0.21)d vs.(4.20±0.32)d]均无显著性差异(P>0.05);2组术后腹股沟区疼痛(1.37%vs.9.72%)、阴囊积液(0vs.5.56%)、异物感(2.74%vs.15.3%)、缺血性睾丸炎(0vs.4.17%)等近远期并发症发生率、恢复正常活动时间[(5.8±1.3)d vs.(7.5±1.6)d],住院费用[(5343±375)元vs.(3977±289)元]均有显著性差异(P<0.05)。结论 M-K术修补成人原发性腹股沟疝可明显减少各种并发症和术后不适的发生率,值得临床推广应用,但存在费用偏高的缺点。

Objective To compare the Modified Kugel herniorrhaphy with Lichtenstein herniorrhaphy in therapeutic efficacy of primary adult inguinal hernia.Methods 145 cases of primary inguinal hernia were randomly blindly treated with either Modified Kugel herniorrhaphy group（72 cases） or Lichtenstein herniorrhaphy group（73 cases）.The duration of operation,hospital stay days,the average length of duration to resume normal activities,cost and recent and long-term operative complications were compared between the two groups.Results No significant difference was found between the two groups in the average duration of operation time[（38±5）min vs.（42±7）min],urinary retention（2.78% vs.2.74%）,and average length of hospital stay [（3.85±0.21）d vs.（4.20±0.32）d]（P 0.05）.However,the post-operative inguinal pain（1.37% vs.9.72%）,scrotal edema（0 vs.5.56%）,foreign body sensation（2.74% vs.15.3%）,and ischemic testitis（0 vs.4.17%） in Modified Kugel herniorrhaphy group was significantly less than those in the Lichtenstein herniorrhaphy group,but the treatment cost in the Modified Kugel herniorrhaphy group was significantly more than those in the Lichtenstein herniorrhaphy group [（5343±375）yuan vs.（3977±289）yuan,P 0.05].Conclusions Modified Kugel herniorrhaphy can significantly reduce the postoperative complications,so it is worthwhile for clinical application,however,the treatment cost of it is higher than Lichtenstein herniorrhaphy.