开放腹膜前修补术治疗成人小型脐疝的临床效果观察

Observation on the clinical effectiveness of open preperitoneal repair in treatment for adults with small umbilical hernia

目的观察开放腹膜前修补术治疗成人小型脐疝的临床效果。方法回顾性分析2018年1月至2022年10月济宁医学院附属金乡医院收治的88例小型脐疝患者的临床资料,根据手术方式将其分为观察组(采用开放腹膜前修补术,n=42)和对照组(采用传统缝合修补术,n=46)。比较两组手术时间、术中出血量、术后视觉模拟量表(VAS)评分、切口愈合等级、住院时间,以及术后血清肿、局部感觉异常、慢性疼痛和复发情况。结果88例患者均顺利完成手术。观察组手术时间显著长于对照组[(51.24±12.64)minvs(42.04±11.88)min;t=3.419,P=0.001]。两组术后VAS评分均呈下降趋势(P<0.05)。在术后第1天和第2天,观察组VAS评分显著低于对照组(P<0.05),两组VAS评分在术后第3天比较差异无统计学意义(P>0.05)。两组术中出血量、切口愈合等级,以及术后血清肿、慢性疼痛、局部感觉异常发生率比较差异无统计学意义(P>0.05)。观察组和对照组中位随访时间分别为19个月和17个月,随访期间观察组无复发,对照组有5例复发,两组复发情况比较差异有统计学意义(log-rank检验:χ_(2)=4.833,P=0.027)。结论开放腹膜前修补术治疗成人小型脐疝安全有效,值得临床推荐。

Objective To observe the clinical effectiveness of open preperitoneal repair in treatment for adults with small umbilical hernia.Methods The clinical data of 88 patients with small umbilical hernia who were admitted to Jin Xiang People′s Hospital Affiliated to Jining Medical University from January 2018 to October 2022 were retrospec-tively analyzed,and the patients were divided into observation group(receiving open preperitoneal repair,n=42)and control group(receiving traditional suture repair,n=46)according to different surgical methods.The duration of surgery,amount of intraoperative blood loss,postoperative Visual Analogue Scale(VAS)score,incision healing grade,length of hospital stay,as well as the postoperative seroma,localized paresthesia,chronic pain and recurrence were compared between the two groups.Results The operations of the 88 patients were successfully completed.The duration of surgery in the observation group was significantly longer than that in the control group[(51.24±12.64)min vs(42.04±11.88)min;t=3.419,P=0.001].The postoperative VAS scores showed a downward trend in both groups(P<0.05).The VAS scores of the observation group were significantly lower than those of the control group on the 1st and the 2nd day after surgery(P<0.05),and there were no significant differences in the VAS scores between the two groups on the 3rd day after surgery(P>0.05).There were no significant differences in the amount of intraoperative blood loss,incision healing grade,as well as the incidence rates of postoperative seroma,chronic pain and localized paresthesia between the two groups(P>0.05).The median follow-up time was 19 months in the observation group and 17 months in the control group.During the follow-up period,there were no cases of recurrence in the observation group and 5 cases relapsed in the control group,and the difference was statistically significant between the two groups(log-rank test:χ_(2)=4.833,P=0.027).Conclusion Open preperitoneal repair is safe and effective in treatment for adults with small umbilical hernia,and is worthy of clinical recommendation.