优质护理辅助疝环充填式无张力疝修补术治疗肾衰竭腹水合并腹股沟疝的疗效分析

Analysis of the curative effect of high-quality nursing assisted mesh-plug tension-free hernia repair in treatment of inguinal hernia complicated with renal failure ascites

目的探讨优质护理辅助疝环充填式无张力疝修补术治疗肾衰竭腹水合并腹股沟疝的疗效。方法收集2016年5月至2019年1月,海南省定安县人民医院治疗腹股沟疝90例肾衰竭伴腹水患者的临床资料,随机分为2组,每组患者45例。所有患者均给予常规肾衰竭伴腹水治疗,常规组采用传统疝修补术进行治疗,并予以院内常规护理;优质组行疝环充填式无张力疝修补术进行治疗,并予以优质护理。观察并比较2组患者的手术时间、术中出血量、术后下床时间、镇痛药应用率、术后疼痛度、并发症发生情况以及复发率。结果优质组患者的术中出血量、下床时间均优于常规组,差异有统计学意义(P<0.05)。优质组手术时间略低于常规组,但差异无统计学意义(P>0.05)。优质组患者术后1、3、7 d VAS评分与常规组比较,差异有统计学意义(P<0.05)。优质组患者术后并发症总发生率明显低于常规组,差别有统计学意义(P<0.05)。优质组患者术后3个月复发率与常规组比较,差异无统计学意义(P>0.05);优质组患者术后6个月复发率与常规组比较,差异有统计学意义(P<0.05)。优质组患者术后镇痛药应用率明显低于常规组,差异有统计学意义(P<0.05)。结论优质护理辅助疝环充填式无张力疝修补术治疗肾衰竭腹水合并腹股沟疝患者的疗效显著,减轻术后疼痛,促进病情恢复,有效降低术后并发症的发生率,值得临床借鉴、推广。

Objective To explore the effect of high-quality nursing assisted mesh-plug tension-free hernia repair in the treatment of inguinal hernia with renal failure ascites.Methods Sixty patients with inguinal hernia complicated with renal failure ascites treated in Dingan County People’s Hospital from May 2016 to January 2019 were randomly divided into the high-quality group(45 cases)and routine group(45 cases).All patients were given routine treatment of renal failure with ascites.The routine group was treated with traditional hernia repair and routine nursing in hospital.The high-quality group was treated with mesh-plug tension-free hernia repair and received high-quality nursing.The operation time,the amount of bleeding,the time of getting out of bed after operation,the application rate of analgesics,the degree of pain after operation,the occurrence of complications and the recurrence rate were observed and compared between the two groups.Results The intraoperative bleeding volume and time of getting out of bed in the high-quality group were less and shorter than those in the routine group(P<0.05).The operation time of the high-quality group was shorter than that of the routine group without significant difference(P>0.05).The score of VAS at 1,3 and 7 days after operation,the total incidence of complications,the application rate of analgesics and the recurrence rate of inguinal hernia at 6 months after operation in the high-quality group were lower than those in the routine group(P<0.05).The recurrence rate at 3 months after operation was not statistically significant between the two groups(P>0.05).Conclusion High-quality nursing assisted mesh-plug tension-free hernia repair is effective in treating patients with inguinal hernia complicated with renal failure ascites.It can alleviate the pain after operation,promote the recovery of the disease,and effectively reduce the incidence of complications after operation.It is worthy of clinical reference and promotion.