局部麻醉下自裁剪免缝合无张力疝修补在腹股沟疝手术中的临床研究

Sutureless tension-free hernia repair in inguinal hernia operation under local anesthesia

目的 比较自裁剪补片与成型网塞补片在无张力疝修补术的临床效果及性价比.方法 回顾性分析2011年1月至2012年6月涿州市医院普外科施行单侧腹股沟疝患者140例,根据采用补片不同分为自裁剪补片组（试验组）与成型网塞补片组（对照组）各70例,比较二组患者手术时间、术后住院时间、住院费用、术后24 h的疼痛及术后3个月慢性疼痛VAS评分,术后异物感等并发症发生情况.结果 试验组手术时间（48±8）min,对照组手术时间（51±9）min,二组手术时间比较差异有统计学意义（t=-2.004,P=0.047）;试验组住院时间（2.1 ± 0.7） d,对照组住院时间（2.3 ± 0.8） d,二组住院时间比较差异无统计学意义（t=-1.414,P=0.160）;术后24 h疼痛VAS评分差异有统计学意义（t=-4.950,P=0.000）;术后3个月慢性疼痛比较差异有统计学意义（χ2=-4.025,P=0.000）;术后异物感差异有统计学意义（χ2=-4.084,P=0.000）;住院费用试验组明显低于对照组,差异有统计学意义（t=-19.095,P=0.000）.随访10～39个月,二组均无复发.结论 利用平补片进行个体化剪裁、免缝合、腹膜前修补的方法进行无张力疝修补术,临床效果与疝环充填式修补术相近,但具有材料价格低、手术时间短、术后疼痛轻及异物感低等优点.

Objective To compare the clinical effect and the value on the trim and fill with mesh plug in the patients with tension-free hernia repair. Methods A total of 140 cases with unilateral inguinal hernia from January 2011 to June 2012 were randomly classified into the test group and the control group, The clinical data of two patients were retrospectively analyzed. The operation time and hospitalization time after operation, the cost of hospitalization, postoperative pain and postoperative 24 hours after 3 months of chronic pain vas score,postoperative foreign body sensation and other complications were compared between the two groups. Results The operation time of the test group lasted （48 ± 8） minutes compared with （51 ± 9） minutes in the control group with statistically significant difference （ t = - 2. 004, P = 0. 047 ） ; The hospitalization time in the test group were （2.1 ± 0.7） days and （2.3 ± 0.8） days in the control group without any significant difference（t = -1. 414,P =0. 160） ; The difference of the 24 hours vas score of the two groups was statistically significant（t = -4. 950 ,P = 0. 000） ;The chronic pain after three months of the two groups was statistically significant x2 = - 4. 025, P = 0.000 ） ; The foreign body sensation between the two groups was statistically significant（32 = -4. 084 ,P = 0.000） ;Hospitalization expenses of test group was significantly lower than that in the control group, and the difference was statistically significant （t = -19. 095 ,P =0.000） ;The follow-up period ranged from 10 to 39 months, and there was no recurrence in two groups. Conclusions The use of patch method was individualized, and sutureless as a kind of preperitoneal repair for the tension-free hernia ring filling. The repair of hernia was effective, safe with rapid recovery, low price, and no foreign body sensation.