局麻下腹膜前间隙与疝环填充修补腹股沟疝的临床疗效分析

A comparative study on the clinical effect of the preperitoneal space and hernia ring filling repairing

目的探讨局麻下腹膜前间隙式腹股沟疝修补术与疝环填充式腹股沟疝修补术治疗腹股沟疝的临床疗效。方法回顾性分析2011年1月-2013年5月在新疆医科大学第一附属医院行局麻下腹膜前间隙式腹股沟疝修补术与疝环填充式腹股沟疝修补术患者的临床资料，局部麻醉下应用巴德疝修补补片Modified Kugel和美外REFTECRT8伞形补片作为疝修补材料行腹股沟疝修补术99例患者，根据手术方式分为腹膜前间隙式组与疝环填充式组。分析两组患者平均手术时间、术后平均住院日、术后并发症情况及术后复发率临床资料。结果腹膜前间隙组与疝环填充组患者平均手术时间分别为（41±7．6）min和（35±6．2）min；术后平均住院日分别为1．9d和2．1d；两组患者术后疼痛较轻，均未用止痛药；两组患者均于术后6～12h下床活动；腹膜前间隙组阴囊积液1例，术后随访5～24个月无术后复发，术后慢性疼痛1例，术后异物感2例；疝环填充组阴囊积液1例，术后随访5～24个月术后复发1例，无术后慢性疼痛患者，术后异物感8例。结论局部麻醉下行腹膜前间隙修补术出现术后异物感方面优于疝环填充式修补术，较疝环填充具有更广的适应证，临床操作中应根据术者手术能力及患者个体情况进行合理化的选择。

Objective A retrospective analysis the data ot 2011--2013-5 in our hospital who repairde the inguinal hernia with open preperitoneal space and hernia ring filling repair both under local anesthesia, discusses two kinds of operative methods in clinical effect in the treatment of inguinal hernia. Methods A ret- rospective analysis in 2011-1--2013-5, 99 patients repaired the inguinal hernia with the Bard Modified Ku- gel and the REFTECRT8 umbrella patch under local anesthesia in our hospital .Depend on the surgical method those patients are divided into open preperitoneal space group and hernia ring filling type group. Observed two groups of patients with average operation time, postoperative clinical data, the postoperative complications, postoperative recurrence o{ such confinement. Results Open preperitoneal space group and hernia ring filling type group, the average operation time, respectively to （41±7.6） min and （35±6.2） min. Postoperative average such confinement were 1.9 d and 2.1 d; Two groups of postoperative pain is light, did not use analgesics; Two groups were recorded in 6 to 12 hours of bed activity; Which the scrotal hydrocele open preperitoneal space group for 1 case, postoperative follow-up 5--24 months no postopera-tlve recurrence, postoperative chronic pain in 1 case, postoperative body sensation in 2 cases; hernia ring filling type group of scrotal hydrocele in 1 case, postoperative follow-up 5 to 24 months postoperative re- currence in 1 case, no postoperative chronic pain patients, 8 cases postoperative body sensation. Conclusion Under local anesthesia, open preperitoneal space repairing in terms of postoperative body sensation is superior to the repair of hernia ring filling type, and wider indications, but there is the risk of damage the abdominal wall of blood vessels, and the femoral vessels when you free the preperitoneal space. It should be according to the performer operation ability, the choice of individual patients condition to choose reason- able method.