无张力疝修补术治疗腹股沟疝

Clinical study on the treatment of inguinal hernia with tension free hernia repair

目的探讨无张力疝修补术治疗腹股沟疝临床疗效。方法回顾性分析2003年3月—2015年6月收治的450例采用无张力疝修补术和传统疝修补术治疗的腹股沟疝患者的临床资料,传统组采用标准Bassini术式,无张力组采用网塞平片疝环充填式行腹股沟疝修补术,所有患者术后行6个月以上随访,观察2组术中出血量、手术时间、下床活动时间、住院时间,采用视觉模拟评分（VAS）量表进行疼痛指数评价,观察术后并发症及复发情况。结果无张力组术中出血量少于传统组,手术时间、下床活动时间、住院时间短于传统组（P〈0.05）;术后第1、3、5天VAS评分无张力组明显低于传统组（P〈0.05）;2组均全部治愈,无感染病例发生,其中无张力组并发症发生率为0.8%,传统组为25.7%,随访3个月~6年,传统组有11例复发,无张力组无复发病例（P〈0.05）。结论疝环充填式无张力疝修补术在手术时间、术后早期反应、下床活动时间、住院天数、VAS评分、并发症等方面显著低于传统组,术后创伤小、恢复快、并发症少、不易复发。

Objective To investigate the clinical effect of tension free hernia repair in the treatment of inguinal hernia. Methods A retrospective analysis of 2003 March- June 2015 from 450 cases with no tension hernia repair and traditional hernia repair surgery in the treatment of inguinal hernia in patients with clinical data,the traditional group using standard Bassini procedure,tension-free group adopted the mesh plug hernia ring filling for inguinal hernia repair surgery,all patients underwent 6 months followed up more than observed in two groups were bleeding,operation time,get out of bed activity time,hospitalization time,using a visual analog scale（ VAS） table for pain evaluation index,postoperative complications and recurrence rate were observed. Results The bleeding volume was less than the traditional group,operation time,bed time,hospitalization time shorter than the traditional group,there was statistical significance（ P〈0.05）; 3D,5D,VAS 1D score was significantly lower than the traditional group（ P〈0. 05）,two groups of patients were all cured,no infection cases occurred,no tension group complications rate was 25. 7%,0. 8% cases were followed up for 6years,there were 11 cases of recurrence in the traditional group,there was statistical significance（ P〈0. 05）. Conclusion The hernia ring filling tension free hernia repair in the operation time,postoperative early reaction,get out of bed activity time,hospital days,VAS score,complications and so on were significantly lower than the traditional group,this operation has the advantages of small trauma,fast recovery,less complications,not easy to relapse.