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两种术式对腹股沟无张力疝修补术的疗效及安全性评价
梁峰,李飞,聂双发,高晓斌
0
(河北北方学院附属第一医院肝胆外科;河北北方学院附属第一医院胃肠外科)
摘要:
【摘要】目的 探讨疝环充填式无张力疝修补术(Rutkow法)和下腹正中切口腹膜前间隙无张力疝修补术(Kugel法)对腹股沟无张力疝的疗效及安全性。方法 选取我院2012年11月~2015年11月收治的130例腹股沟无张力疝患者,据手术方式不同分为Rutkow组(采用Rutkow法)和kugel组(采用Kugel法)两组,每组各65例,所有患者均给予相同标准化处理流程,记录对比两组患者的手术情况、术后并发症情况、术后疼痛评分(VAS)及术后复发率。结果 两组患者手术时间、术后住院时间、下床活动时间和术后恢复时间比较差异无统计学意义(P>0.05);Kugel组术后并发症总发生率显著低于Rutkow组(P<0.01),两组经积极对症处理后均未留下明显后遗症;术后各阶段,Kugel组的VAS评分均显著低于Rutkow组(P<0.01);Rutkow组共有2例复发,Kugel组无复发(P>0.05)。结论 采用下腹正中切口行kugel法行腹膜前间隙无张力疝修补术,可有效降低术后疼痛、并发症发生率、复发率,安全性高,同时不需要更多的手术时间及术后恢复时间,临床疗效及安全性好。
关键词:  疝环充填式无张力疝修补术  下腹正中切口  腹膜前间隙无张力疝修补法  临床疗效  安全性
DOI:
基金项目:河北省医学科学研究重点课题计划(201603 57)
Efficacy and safety of tension free inguinal hernia repair with mesh plug and tension free repair of preperitoneal space with middle abdominal incision
LIANG Feng,LI Fei,NIE Shuangfa,GAO Xiaobin
(Department of Hepatobiliary Surgery, The First Affiliated Hospital of Hebei North College;Department of Gastrointestinal Surgery, The First Affiliated Hospital of Hebei North College)
Abstract:
【Abstract】 Objective To investigate the efficacy and safety of tensionfree inguinal hernia repair with mesh plug (with Rutkow as an example) and tensionfree repair of preperitoneal space with the middle incision of lower abdomen (with Kugel as an example). Methods 130 patients with inguinal hernia admitted in our hospital from November 2012 to November 2015 were selected and divided into two groups according to the way of operation. All patients were given the same standardized treatment procedure. The two groups were respectively treated with Rutkow and Kugel methods. The operation, postoperative complications, postoperative pain scores (VAS) and postoperative recurrence rates were recorded and compared between the two groups. Results There were no statistical difference of operation time, postoperative hospital stay, ambulation time and postoperative recovery time between the two group (P>005). The total incidence of postoperative complications in Kugel group was significantly lower than that in Rutkow group (P<001). The two groups did not leave any obvious sequelae after the positive symptomatic treatment. The scores of VAS in the Kugel group were significantly lower than those in the Rutkow group at each stage after operation (P<001). There were 2 cases of recurrence in Rutkow group, but there was no recurrence in Kugel group. Conclusion The repair surgery of the tensionfree repair of preperitoneal space with Kugel as an example can effectively reduce the postoperative pain, complication rate and recurrence rate. It does not need more operative time and postoperative recovery time.
Key words:  Tension free inguinal hernia repair with mesh plug  Median lower abdominal incision  Preperitoneal space tension free hernia repair  Clinical efficacy  Safety

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