开放式腹膜前间隙修补术与疝环填充式无张力疝修补术治疗成人腹股沟斜疝的疗效分析

Clinical analysis of open preperitoneal repair and Rutkow hernioplasty in the treatment of adult indirect inguinal hernia

目的比较开放式腹膜前间隙无张力疝修补术和疝环填充式无张力疝修补术(Rutkow)治疗成人腹股沟斜疝的临床疗效。方法回顾性分析西安文理学院协作医院西安市第一医院2010年5月至2013年9月收治的90例原发性单侧腹股沟斜疝成年男性患者的临床资料,随机分为开放式腹膜前间隙疝修补术组和疝环填充式无张力疝修补术组(Rutkow组),比较二组手术一般情况、术后并发症情况及复发率。结果二组患者术后疼痛评分比较,差异有统计学意义[(2.0±0.3)分vs(3.9±0.8)分,P<0.05];二组异物感比较,分别为2例和13例,差异有统计学意义(P<0.05)。二组患者平均手术时间、术后下床时间、平均住院时间、术后阴囊水肿、切口感染、补片感染、尿潴留以及手术复发率对比,差异有统计学意义(P<0.05)。结论两种手术方式均是安全有效的修补方式,开放式腹膜前间隙修补术后疼痛程度轻,异物感少,修补更彻底,值得推广。

Objective To evaluate the clinical effect of open preperitoneal repair and Rutkow hernioplasty in the treatment of adult indirect inguinal hernia. Methods The clinical data of 90 patients with indirect inguinal hernia admitted from May 2010 to September 2013 in Xi＇ an First Hospital,Xi＇ an University,were reviewed retrospectively. The patients were randomly divided into open preperitoneal repair group（ n = 45） and Rutkow hernioplasty group（ n = 45）. Operation details,postoperative complications,foreign body sensation,postoperative pain score and recurrence were compared in two groups. Results The postoperative pain score and foreign body sensation in open preperitoneal repair group were significantly lower than those in Rutkow hernioplasty group（ P 0. 05）. There were no significant differences in operative time,postoperative ambulation time,hospital stay,postoperative complications,and recurrence rate between the two groups（ P 0. 05）. Conclusion Both open preperitoneal repair and Rutkow hernioplasty are safe and effective treatment for adult indirect inguinal hernia. Open preperitoneal repair shows to have milder pain and less foreign body sensation,and it is worthy of popularization and application.