局部麻醉下网塞充填式与平片式无张力修补术治疗腹股沟疝的临床对比观察

Clinical comparative study between mesh plug and flat mesh tension- free repair for inguinal hernia under local anesthesia

目的：比较局部麻醉下网塞充填式与平片式修补术式治疗腹股沟疝的疗效。方法回顾性分析2008年4月至2013年4月，北京中医药大学附属护国寺中医医院收治的腹股沟疝患者126例，随机分为二组，A组74例患者采用网塞充填式修补方法，B组52例患者采用平片式无张力修补方法。观察比较二组患者的手术时间、术后并发症、住院时间、住院费用以及术后近期复发情况。结果二组患者术后在阴囊积液、术后慢性疼痛、复发率上比较，差异无统计学意义（χ2＝0．312、2．625、1．201，P＝0．542、0．302、0．135）；在术后异物感上，A 组高于 B 组，差异有统计学意义（χ2＝13．232，P＝0．000）。二组患者手术时间、平均住院费用等情况比较差异有统计学意义（t＝2．823、403．518，P均＝0．001），住院时间比较差异无统计学意义（t＝－0．012，P＝0．981）。术后随访6-12个月，二组患者均无复发。结论二种手术治疗腹股沟疝均疗效确切、安全、复发率低，但平片无张力修补术式操作简单，术后并发症少，费用低廉。

Objective To compare the efficacy of mesh plug repair and flat mesh repair for inguinal hernia under local anesthesia.Methods A retrospective study was performed.From April 2008 to April 201 3,1 26 patients of inguinal hernia who were admitted to Huguosi Hospital of Traditional Chinese Medicine,were randomly divided into two groups：74 patients in group A using plug mesh and 52 patients in group B using flat mesh.The operating time,complications,hospital stay,cost and short-term recurrence were compared both in the two groups.Results There were no significant differences between two groups in postoperative complications regarding scrotal seroma or recurrence rate （χ2 =0.312,2.625,1 .201 ,P =0.542,0.302,0.1 35）;foreign body sensation was fewer in group B compared with group A （χ2 =1 3.232, P=0.000）.The operating time and average cost of hospitalization were significantly different between two groups（t=2.823,403.51 8,all P=0.001 ）,while there was no difference in terms of the length of stay（t=-0.01 2,P =0.981 ）.After a follow-up of 6 to 1 2 months,no recurrence occurred in two groups. Conclusion Both two procedures areshown to be safe and effective,but flat mesh tension-free repair can be easy to perform and has the advantages of less complications and few cost.