Lichtenstein无张力疝修补术治疗成人腹股沟嵌顿疝临床分析

Clinical Analysis on Lichtenstein Tension-free Herniorrhaphy for Adult Patients with Incarcerated Inguinal Hernia

目的探讨应用 Lichtenstein 无张力疝修补术治疗成人腹股沟嵌顿疝的临床效果分析。方法回顾性分析我院 2015 年 1 月~ 2018 年 6 月应用 Lichtenstein 无张力疝修补术治疗的 374 例腹股沟疝患者的临床资料,其中 48 例嵌顿疝患者行急诊手术纳入研究组,326 例非嵌顿疝患者行择期手术纳入对照组。观察并比较两组患者平均手术时间、住院时间、术中出血量、放置引流、使用抗菌素、术后并发症、术后疼痛及复发率。结果两组术中出血量比较无统计学差异( P>0.05),但研究组手术时间、住院时间明显长于对照组,负压引流和抗菌素使用率也高于对照组,差异均有统计学意义( P<0.05)。两组术后并发症、术后疼痛 VAS 评分及复发率比较,差异均无统计学意义( P>0.05)。结论在仔细手术操作、积极负压引流以及合理使用抗菌素的前提下,应用 Lichtenstein 无张力疝修补术治疗腹股沟嵌顿疝是安全有效的。

Objective To explore the clinical effect of Lichtenstein tension-free herniorrhaphy in the treatment of adult patients with incarcerated inguinal hernia. Methods A retrospectively study of 374 patients with inguinal hernia treated by Lichtenstein tension-free from January 2015 and June 2018 in our hospital were performed,including the emergency surgery in 48 patients with incarcerated hernia ( as the study group) and the selective surgery in 326 cases with inguinal hernia ( as the control group). The average operation time,hospitalization time,amount of bleeding,drainage tube placed,antibiotics application rate,complications,pain scores and recurrence were compared between the two groups. Results There was no statistical difference in intra-operative blood loss between the two groups( P> 0. 05),but the average operation time and hospitalization time of the study group were longer,and the rate of drainage tube placing and antibiotics application of the study group were higher than those of the control group ( P < 0. 05 ). No statistical differences in complications,pain scores and recurrence rate between the two groups ( P > 0. 05 ). Conclusion Lichtenstein tension-free herniorrhaphy is a safe and effective surgical intervention for incarcerated inguinal hernia under the premised of careful operation,positive drainage and rational antibiotics application.