结合腹横筋膜修补的Lichtenstein手术95例临床分析

Clinical Effects of Lichtenstein Combined with Transverse Abdominal Fascia Repair

目的探讨结合腹横筋膜修补的Lichtenstein手术的临床效果。方法回顾分析2005年2月-2011年12月95例腹股沟疝治疗的临床资料,95例腹股沟疝行Lichtenstein手术中同时行腹横筋膜折叠缝合及内环修补。95例中Ⅰ型疝29例,Ⅱ型疝45例,Ⅲ型疝16例,Ⅳ型疝5例(复发疝)。并存病:高血压30例,心脑血管疾病25例,糖尿病18例,前列腺增生19例,慢支肺气肿12例。结果 95例患者术后主要并发症为血清肿7.4%(7/95);尿储留7.4%(7/95);暂时性神经感觉异常4.2%(4/95),经穿刺抽吸、加压包扎、保留导尿、理疗等处理短期内均痊愈。无严重并发症,无牵拉感、异物感,疼痛轻、恢复快,随访1～5年无复发率。结论该手术术式合理,符合现代疝外科理论,符合无张力疝修补原则,临床疗效好,适应症广。

Objective To study the clinical effects of Lichtenstein combined with transverse abdominal fascia repair. Methods Retrospective analysis of clinical information of the treatment of 95 cases of inguinal hernia from February 2005 to De- cember 2011 in our hospital,95 cases received Lichtenstein inguinal hernia surgery abdominal transverse fascia plieation and in- ner ring patch. In 95 cases of hernia ： report of 29 cases of type I hernia,report of 45 cases of type II, 16 cases of III hernia,and type four 5 cases （ recurrent hernia）. The coexisting diseases：30 cases of hypertension, cardio-cerebral vascular diseases in 25 ca- ses, 18 cases of diabetes mellitus, 19 cases of hyperplasia of prostate, and chronic bronchitis emphysema in 12 cases. Results 95 cases of postoperative complications were blood bruises （ 7.4% ）, urinary retention （ 7.4% ） ; and temporary nerve paresthesia （4.2%）, All were recovery with aspiration, compression bandage, retaining urinary c/ttheter, and physiotherapy. No serious com- plications occurred ,with no sense of strain, foreign body sensation ,light pain, and with faster recovery, and no recurrence by fol- lowing-up 1 - 5 years. Conclusion The surgery was reasonable, consistent with the modern theory of hernia surgery,in line with the principle of tension-free hernia repair ,with good clinical efficacy, and wide range of indication.