采用不同术式腹股沟疝修补术后的超声随访比较

Comparative study of ultrasonographic manifestations after inguinal hernia repair with different surgical methods

目的对比采用不同术式的腹股沟疝修补术后并发症的超声表现。方法回顾性分析2015年8月至2016年10月,首都医科大学附属北京朝阳医院治疗的初发腹股沟疝228例患者的临床资料,记录患者的一般情况及手术方式,并对其进行定期超声检查,观察补片位置、大小、形态、与四周组织的融合情况以及周围组织有何异常。结果本研究共纳入符合条件的228例患者,术后定期超声检查,阳性超声表现39例,包括感染、血肿/血清肿、尿潴留、脂肪液化、精索水肿、阴囊壁水肿、鞘膜腔积液、睾丸肿大或睾丸萎缩、复发等,21例行开放式无张力疝修补术,18例行腹腔镜疝修补术,阴性超声表现189例,59例行开放式无张力疝修补术,130例行腹腔镜疝修补术,超声观察采用不同术式腹股沟疝术后并发症的发生率及种类,结果有统计学差异。结论彩色多普勒超声在腹股沟疝术后随诊中具有一定的应用价值,腹腔镜疝修补术较开放式无张力疝修补术术后并发症的发生率更低。

Objective To investigate the significance of color Doppler ultrasonography in inguinal hernia repair after different surgical procedures. Methods The data of 228 primary inguinal hernia patients in Beijing Chao-Yang hospital from August 2015 to October 2016 were retrospectively analyzed. The general condition and operative data was recorded,and the regular ultrasonography after operation was performed.The location,size,shape,and integration of the mesh were observed. Results In this study,228 patients were included. There were 39 cases of positive presentation in the regular ultrasound examination,including infection,hematoma/seroma,urinary retention,fat liquefaction,spermatic cord edema,scrotal wall edema,hydrocele,testicular swelling or testicular atrophy,and recurrence etc. Of these,21 cases were treated with open tension-free hernia repair,18 cases were treated with laparoscopic hernia repair. There were 189 cases of negative ultrasonography,of which 59 cases were treated with open tension-free hernia repair and 130 cases were treated with laparoscopic hernia repair. The incidence and type of postoperative complications of inguinal hernia with different surgical procedures were observed by ultrasonography. The results were statistically different. Conclusion Color Doppler ultrasonography has a certain value in follow-up of inguinal hernia repair. The incidence of postoperative complications with laparoscopic hernia repair is lower than that of open tension-free hernia repair.