无张力疝修补术与巴西尼修补术治疗嵌顿性斜疝的对比研究

Comparison of tension-free hernioplasty and Bassini hernia repair on treating incarcerated indirect inguinal hernia

目的比较无张力疝修补术与传统巴西尼修补术治疗急诊嵌顿性斜疝的临床疗效。方法收集56例嵌顿性斜疝患者的临床资料,其中无张力修补术26例(无张力组),巴西尼修补术30例(巴西尼组),比较两组治疗效果。结果两组在体重指数、既往疝病史、嵌顿时间、术前白细胞、术后切口感染、复发、慢性疼痛等方面比较,差异均无统计学意义(t分别=0.82、1.21、0.36、1.14,χ^(2)分别=0.35、0.42、0.84,P均>0.05)。与无张力组比较,巴西尼组平均年龄更高,疝囊更大,手术时间较短,住院总费用较低,合并较多的基础疾病,美国麻醉医师协会(ASA)麻醉分级更高,远期病死率较高,差异均有统计学意义(t分别=2.42、2.71、3.36、4.94,χ^(2)分别=4.35、5.42、4.84,P均<0.05)。结论腹股沟嵌顿疝应根据患者情况采用个体化手术方式,使用补片行无张力修补是安全、可行的,但对于高龄、基础疾病多、预期寿命有限的患者可以采取传统巴西尼修补术。

Objective To compare the clinical application of tension-free hernioplasty and traditional Bassini hernia repair on treating incarcerated indirect inguinal hernia.Methods Totally 56 patients with incarcerated indirect inguinal hernia were selected,26 patients were treated with tension-free hernioplasty(tension-free group),and 30 patients under-went traditional Bassini hernia repair(Bassini group),The difference of treatment effect was compared between the two groups.Results There were no statistically significant differences in the body mass index,hernia history,incarceration time,preoperative white blood cell,postoperative incision infection,recurrence,and chronic pain between the two groups(t=0.82,1.21,0.36,1.14,χ^(2)=0.35,0.42,0.84,P>0.05).Compared with the tension-free group,the Bassini group has hig-her average age,bigger hernia sac,shorter operation time,less hospitalization cost,more underlying diseases,higher ASA grading and higher long-term mortality(t=2.42,2.71,3.36,4.94,χ^(2)=4.35,5.42,4.84,P<0.05).Conclusion Surgeons should choose the different operation style according to the patient's condition,tension-free hernioplasty in emergency treatment of incarcerated indirect inguinal hernia is safe and effective.The Bassini hernia repair is suitable for the elder-ly,more underlying diseases and limited life expectancy patients.