微创腹膜前修补治疗腹股沟疝的临床价值分析(1)
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[摘要] 目的 比较Kugel疝修补术与腹腔镜疝修补手术用于腹股沟疝修补术的临床疗效。方法 将2008年1月～2009年5月来我院进行手术治疗的腹股沟疝患者分为两组，Kugel组采用Kugel补片开放式腹膜前修补，TEP组采用腹腔镜下完全腹膜外腹股沟疝修补，对比两组的术后并发症、住院天数、恢复正常活动天数，术后随访24个月并对比其复发率。 结果 两组患者手术时间、手术后住院时间、恢复正常活动天数差异无明显统计学意义(P>0.05)，而手术出血量Kugel组少于TEP组，差异有明显统计学意义(P<0.05)，两组随访24个月均未发现复发患者，并且两组并发症发生率差异无明显统计学意义(P>0.05)。结论 Kugel疝修补术具有微创、术后恢复快、并发症少、疗效确切等特点，值得临床推广应用。
[关键词] 腹股沟疝；Kugel补片；疝修补术
[中图分类号] R656.2+1 [文献标识码] B [文章编号] 1673-9701(2011)26-148-02
Clinical Value of Minimally Invasive Preperitoneal Repair in the Treatment of Inguinal Hernia
LIU Jianyang
Zhejiang Quhua Hospital， Quzhou 324000， China
[Abstract] Objective To compare the effects of Kugel hemioplasty and totally extraperitoneal prosthesis on patients with inguinal hernia. Methods Patients of our hospital from January 2008 to May 2009 for surgical treatment of inguinal hernia were divided into two groups. Kugel group adopted Kugel patch with an open preperitoneal repair， and TEP group received laparoscopic totally extraperitoneal inguinal hernia repair； Postoperative complications， hospital stay， return to normal activity days of two groups were compared. Patients were followed up for 24 months and the recurrence rates were compared. Results Operative time， postoperative hospital stay，number of days to resume normal activities of two groups had no statistically significant difference (P>0.05)；and blood loss of the Kugel group was less than that of the TEP group， and the difference was statistically significant (P<0.05)；Two groups were followed up for 24 months and patients with recurrence were not found，and incidence of complications in both groups had no statistically significant difference (P>0.05). Conclusion Kugel hernia repair has features of minimal invasion， rapid postoperative recovery， fewer complications and definite efficacy，and is worthy of clinical application.
[Key words] Inguinal hernia； Kugel patch； Hernia repair
20世纪90年代Kugel根据腹腔镜腹膜手术原理，设计出Kugel补片并用于临床。应用Kugel补片开放式腹膜前修补腹股沟疝因不需要过多解剖周围组织，补片就可以直接置人腹膜前间隙内，对血管和神经损伤较小，手术创伤小，术后恢复快，并发症较少，因此Kugel手术被称为腹股沟疝微创手术[1]，但其与腹腔镜疝修补手术特别是完全腹膜外腹股沟疝修补(totally extraperitoneal prosthesis，TEP)对比研究较少。鉴于此，本研究采取病例对照的研究方式来探讨两者的优缺点 ......
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