Modified Kugel与李金斯坦修补术治疗成人腹股沟疝的对比分析

Comparison of Modified Kugel and Lichtenstein repair in adult hernias

目的通过前瞻性临床对照研究比较Modified Kugel(M-K)修补术和李金斯坦(Lichtenstein)修补术的临床效果。方法选取2010年8月至2012年4月在上海交通大学医学院附属新华医院治疗的218例成人腹股沟疝患者,随机分为接受M-K手术治疗(观察组)和Lichtenstein术治疗(对照组)。比较二组平均手术时间、术后住院天数、恢复正常活动时间、住院费用以及近、远期并发症等临床资料。结果二组在平均手术时间、平均住院时间、恢复正常活动时间、术后阴囊血肿、局部血清肿、精索水肿、心脑血管意外发生率比较差异均无统计学意义(t=1.262、0.849、1.282,χ2=1.005、0.338、0.338、0.338,P均>0.05);对照组局部异物感发生率及住院费用低于观察组,比较差异均有统计学意义(χ2=4.670,14.236,P均<0.05)。结论 M-K术是一种创伤小、恢复快、安全的无张力修补方式,在有复发高危因素的患者身上使用具有降低复发率的优势。

Objective To compare the efficacy of Modified Kugel （M-K） repair and Lichtenstein repair in the prospective clinical study. Methods A total of 218 cases of adult patients with inguinal hernia from August 2010 to April 2012 in the Xinhua Hospital Affilated to Shanghai Jiao Tong University School of Medicine were enrolled and randomized to receive treatments of Lichtenstein （ control group） and M-K repair （obsevation group）. The mean operation time, postoperative hospitalization stau, cost of hospitalization and complication were assessed. Results No differences were observed in the mean operation time, length of postoperative hospitalization stay, the recovering time, hematoma of scotum, local seroma, spermatic edmma, and cardiovascular cerebrovascular accident rate （ t = 1. 262,0. 849,1. 282 9（2 = 1. 005,0. 338,0. 338, 0. 338, P all 〈 0.05 ）. Local foreign body sensation and cost of hospitalization in control group were less than those in obsevation group （X2 = 4.670,14. 236, P all 〈 0.05 ）. Conclusion The M-K repair is a reliable tension-free operation with rapid recovery, especially for those patients with high risk of recurrence.