两种不同无张力修补术在治疗腹股沟疝中的临床疗效对比研究

Comparative study of two different tension-free repairs in the treatment of inguinal hernia

目的探讨腹股沟疝患者行李金斯坦无张力修补术和疝环无张力修补术的临床疗效,以期为临床中手术方式的选择提供参考。方法回顾性分析2015年1月—2016年1月本院收治的69例腹股沟疝患者的临床资料,其中观察组(37例)采用李金斯坦无张力疝修补术,对照组(32例)采用疝环无张力修补术,分析比较两组患者的手术时间、临床疗效、术后住院天数、换药次数、术后腹股沟区异物感发生率、切口周围疼痛情况和术后切口感染、血清肿等并发症的情况。结果两组患者术后1个月评价临床疗效均为100%,治愈率一致。两组患者在平均手术时间、术后首次通气平均时间、术后住院时间、术后并发症发生率的比较上未见明显差异(P>0.05),所有患者术后并发症为Ⅰ～Ⅱ级,经积极治疗后术后1个月内均治愈。所有患者随访至术后6个月,两组均未见复发患者,两组无差异。两组患者在术后换药次数、术后完全恢复正常活动平均时间、术后1周VAS评分的比较上有明显统计学差异(P<0.05)。结论李金斯坦无张力修补术和疝环无张力修补术在治疗腹股沟疝时均能达到较高的治愈率和较少的复发率。两种术式术后均有一定的并发症,但积极处理后均治愈,两种术式均安全有效。李金斯坦术能显著减轻患者术后腹股沟区的疼痛,能一定程度上加快患者术后恢复正常生活的时间。

Objective To investigate the clinical efficacy of Lichtenstein herniaoplasty and plug and mesh hernia repair in patients with inguinal hernia,in order to provide reference for the choice of surgical methods in clinical practice.Methods The clinical data of patients with inguinal hernia admitted to our hospital from January 2015 to January 2016 were retrospectively analyzed.The observation group was treated with Lichtenstein herniaoplasty,and the control group was treated with plug and mesh hernia repair.The patient's operation time,clinical efficacy,postoperative hospital stay,number of dressing changes,incidence of postoperative inguinal foreign body sensation,pain around the incision,postoperative incision infection,seroma and other complications of the two groups were compared.Results The clinical efficacy of the two groups of patients evaluated at one month after surgery was 100%,and the cure rate was consistent.There was no significant difference in the average operation time,the average time of first ventilation,postoperative hospital stay,and postoperative complication rate between the two groups(P>0.05).All patients had postoperative complications of grade I-II.After active treatment,it was cured within 1 month after operation.All patients were followed up for 6 months after surgery,and no recurrence was found in either group.There was no difference between the two groups.There were significant differences in the number of postoperative dressing changes,the mean time to complete normal recovery after surgery,and the VAS score at 1 week after surgery(P<0.05).Conclusions Both Lichtenstein herniaoplasty and plug-mesh hernia repair could achieve a higher cure rate and less recurrence rate in the treatment of inguinal hernia.Both procedures had certain complications,but they could be cured after active treatment.Both procedures were safe and effective.Lichtenstein herniaoplasty could significantly reduce the pain in the inguinal region of patients after surgery,which could accelerate the recovery time to normal life after surgery.