杂交技术在成人腹股沟嵌顿疝治疗中的应用研究

Application of hybridization technique in the treatment of adult inguinal hernia

目的探讨分析杂交技术在成人腹股沟嵌顿疝治疗中的应用效果和安全性。方法选取2016年2月至2019年5月,惠州市第一人民医院及中信惠州医院收治的腹股沟嵌顿疝成年患者114例,其中惠州市第一人民医院患者53例,中信惠州医院患者61例。随机分为A、B、C组,A组给予杂交技术疝修补术治疗,B组给予传统切开无张力疝修补术治疗,C组给予腹腔镜下无张力疝修补术治疗,比较3组临床疗效、手术指标、恢复指标及术后并发症发生率。结果A组临床疗效总有效率97.37%均高于B组73.68%和C组84.21%,C组高于B组,差异均有统计学意义(P<0.05);3组总有效率比,差异有统计学意义(P<0.05);3组显效、有效、无效发生情况比较,差异有统计学意义(P<0.05)。A组手术时间、术中出血量均显著高于B、C组;B组手术时间短于C组,术中出血量多于C组,差异均有统计学意义(P<0.05)。3组手术时间和术中出血量比较,差异均有统计学意义(P<0.05)。C组术后下床时间、住院时间,显著低于A、B,差异有统计学意义(P<0.05);A、B组术后下床时间比较,差异无统计学意义(P>0.05);A、B组住院时间比较,差异有统计学意义(P<0.05);3组术后下床活动时间和住院时间比较,差异有统计学意义(P<0.05)。B组术后并发症发生率显著高于A、C组,差异均有统计学意义(P<0.06)。A、C组术后并发症发生率比较,差异无统计学意义(P>0.05)。3组术后并发症总发生情况比较,差异有统计学意义(P<0.05)。结论杂交技术应用于成人腹股沟嵌顿疝治疗可显著提高临床疗效,且安全可靠,但是术前需严格评估患者病情,若疝嵌顿时间较长,出现腹膜炎症状需要及早行传统开放手术,改善患者的预后。

Objective To investigate the application effect and safety of hybridization technique in the treatment of adult inguinal hernia.Methods To select 114 adult patients from The First People's Hospital of Huizhou City(n=53)and Zhongxin Huizhou Hospital(n=61)with incarcerated hernia between February 2016 to May 2019 divide them into groups A,B and C randomly.Group A was given hybrid technique for hernia repair,group B was treated with conventional incision tension-free hernia repair,and group C was treated with laparoscopic tension-free hernia repair.Compare the clinical efficacy,surgical index,recovery index and postoperative complication rate between the two groups.Results The total effective rate of clinical efficacy was 97.37%in group A,which was significantly higher than that in group B and C.The longest operation time in group A was(90.23±15.10)minutes and the maximum amount of intraoperative blood loss was(14.95±1.87)ml.Bed time(21.34±6.27)hours was significantly shorter than A and B,and group C was the shortest(3.50±1.11)days,the difference was statistically significant(P<0.05).There was no difference in bedtime after operation in group A and B.Statistical significance(P>0.05),the highest postoperative complications in group B was 23.68%,the difference was statistically significant(P<0.05),but there was no significant difference in the incidence of postoperative complications in group A and C(P>0.05).Conclusion Hybridization technique can significantly improve the clinical efficacy in the treatment of adult inguinal hernia,but it is safe,safe and reliable.However,it is necessary to strictly evaluate the patient's condition before surgery.If the incarceration time is longer,the symptoms of peritoneal inflammation need to be early.Traditional open surgery is performed to improve the prognosis of patients.