无张力疝修补术治疗腹股沟疝91例临床分析
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[摘要] 目的 探讨无张力疝修补术治疗腹股沟疝的临床疗效。方法 选取2007年1月～2009年3月于本院进行治疗的182例腹股沟疝患者为研究对象，将其随机分为对照组(传统疝修补法组)91例和观察组(无张力疝修补术组)91例，后将两组患者术后VAS评分、手术时间、下地时间、住院时间、并发症发生率、患者满意率及术后24个月的复发率进行比较。结果 观察组的术后VAS评分低于对照组，手术时间、下地时间、住院时间短于对照组，并发症发生率及术后24个月的复发率低于对照组，患者满意率高于对照组，均差异有统计学意义(P < 0.05)。结论 无张力疝修补术治疗腹股沟疝的临床疗效明显优于传统的疝修补术，可显著改善多个评估项目，综合优势明显。
[关键词] 无张力疝修补术；传统疝修补术；腹股沟疝；临床疗效
[中图分类号] R656.2+1 [文献标识码] B [文章编号] 1674-4721(2012)02(b)-0184-02
The clinical analysis of 91 patients with inguinal hernia by tension-free hernioplasty
CHEN Baohua
Department of Surgery, Maternal and Child Health Hospital of Pingyu County in Henan Province, Pingyu 463400, China
[Abstract] Objective To study the clinical effects of tension-free hernioplasty in inguinal hernia. Methods One hundred and eighty-two cases of patients with inguinal hernia in our hospital from January 2007 to March 2009 were selected as research object, and they were randomly divided into control group(traditional herniorrhaphy group) 91 cases and observation group(tension-free hernioplasty group) 91 cases, then the VAS score, operation time, activity time, hospitalization time,incidence of complications, patients′ satisfaction rate and recurrence rate after operation at 24 month of two groups were analyzed and compared. Results The VAS score of observation group was lower than that of control group, operation time,activity time, hospitalization time were shorter than those of control group, incidence of complications and recurrence rate after operation at 24 month were both lower than those of control group, patients′ satisfaction rate was higher than that of control group, differences were all significant (P < 0.05). Conclusion The effects of tension-free hernioplasty in inguinal hernia is better than traditional herniorrhaphy, and it can significantly improve many items, and its comprehensive advantages is obvious.
[Key words] Tension-free hernioplasty；Traditional herniorrhaphy；Inguinal hernia；Clinical effects
腹股沟疝是发生在腹股沟区的腹外疝，男性多见，如治疗不及时可能可发生嵌顿和绞窄而威胁患者的生存质量，甚至生命[1]。本病的保守治疗效果不好，一般则需手术进行治疗。本文中笔者就无张力疝修补术治疗腹股沟疝的临床疗效进行观察，现将结果总结报道如下：
1资料与方法
1.1一般资料
选取2007年1月～2009年3月于本院进行治疗的182例腹股沟疝患者为研究对象，均为单侧疝，将其随机分为对照组(传统疝修补法组)91例和观察组(无张力疝修补术组)91例。对照组的91例患者均为男性，年龄22～75岁，平均(52.1±5.3)岁，左侧45例，右侧46例，分类：斜疝68例，直疝23例。观察组的91例患者均为男性，年龄23～74岁，平均年龄(53.0±5.2)岁，左侧44例，右侧47例，分类：斜疝69例，直疝22例。两组患者各项基本资料比较，差异无统计学意义(P > 0.05)，具有可比性。
1.2方法
对照组采用传统的疝修补术进行治疗，麻醉后高位切断，结扎疝囊颈。观察组采用无张力疝修补术进行治疗，在对照组的基础上，用丝线在疝囊颈部(内环处)作荷包口或贯穿缝合，剪去多余的疝囊壁，荷包口的远端再以丝线贯穿缝合一次，根据缺损程度选用网塞的数目，采用补片放置缝补固定，注意网塞的内侧应直至腹直肌的外侧缘，并将其修剪至圆形状，还有注意补片周围要有一定的松弛度以避免其缩水。后将两组患者术后VAS评分、手术时间、下地时间、住院时间、并发症发生率、患者满意率及术后24个月的复发率进行统计及比较。
1.3评价标准
VAS评分是疼痛视觉模拟评分，以0～10分为评估范围，0分为无痛，10分为最痛，由患者根据自我感觉疼痛程度进行分数的评估[2]。
1.4统计学处理 ......
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