经腹膜前间隙与疝环填充式无张力疝修补术治疗腹股沟疝临床疗效对比研究

Comparison of the clinical effects of periperitoneal repair and mesh-plug herniorrhaphy in the treatment of inguinal hernia

目的探讨经腹膜前间隙与疝环填充式无张力疝修补术治疗腹股沟疝临床疗效对比,以期为临床提供相关依据。方法随机选取2013年1月至2016年1月,汉中市勉县医院收治的腹股沟疝患者60例,根据随机表对照法分为A组30例,B组30例,其中A组采用经腹膜前间隙无张力腹股沟疝修补术治疗,B组采用疝环填充式无张力腹股沟疝修补术治疗。对2组患者治疗结果进行对比分析。结果 A组和B组患者的平均手术时间分别为(43±6)min和(38±5)min,2组对比差异无统计学意义(P<0.05)。2组患者分别于5、10、15 h及1个月进行视觉模拟评分法(VAS)评估,其中术后1个月的VAS评估,A组患者的疼痛感较B组显著减轻,差异有统计学意义(P<0.05)。而术后5、10、15 h的VAS评估差异均无统计学意义(P>0.05)。A组患者术后并发症情况,阴囊水肿3例,其它均无。B组患者术后并发症情况,阴囊水肿5例、皮下血清肿5例、术后异物感11例。其中术后异物感2组比较,差异有统计学意义(P<0.05)。结论 A组患者的治疗效果优于B组患者,经腹膜前间隙无张力腹股沟疝修补术的治疗效果优于疝环填充式无张力腹股沟疝修补术。

Objective To investigate the clinical effect of preperitoneal inguinal hernia repair and mesh- plug tension-free herniorrhaphy in treatment of inguinal hernia, so as to provide the relevant evidence for clinical practice. Methods From January 2013 to January 2016, 60 cases with inguinal hernia admitted to Mianxian Hospital was enrolled. According to random table method, the patients were divided into group A （ n = 30） and group B （n =30）. Patients in group A were treated with periperitoneal inguinal hernia repair, while group B was operated by mesh-plug repair. The results of the two groups of patients were analyzed. Results The mean operative time of group A and group B was （43 ±6） minutes and （38 ±5） minutes, respectively. There was no statistically significant difference between the two groups （P 〈 0. 05 ）. The visual analogue scale （VAS） was evaluated at 5, 10, 15 hours and 1 month after operation. The pain of group A was significantly less than that of group B at 1 month after operation, The difference was statistically significant （P〈0. 05）. There was no statistically significant difference in VAS scores at 5, 10 and 15 hours after operation （P 〉 0. 05 ）. The postoperative complications of patients in group A showed scrotal edema in 3 cases. In group B, postoperative complications occurred scrotal edema in 5 cases, subcutaneous seroma in 5 cases, and postoperative foreign body sensation in 11 cases. There was significant difference between the two groups （P 〈 0. 05）. Conclusion Treatment effect of patients in group A was better than that in group B. The periperitoneal tension-free inguinal hernia repair seems to be superior to mesh-plug hernia repair in treatment effect.