前后入路無張力疝修補術治療成人腹股溝疝的臨床對比研究

[摘要]目的 探討后入路無張力疝修補術的臨床價值及優越性。 方法 將82例腹股溝疝患者分為觀察組和對照組，觀察組給予后入路無張力疝修補術，對照組給予前入路無張力疝修補術，觀察兩組患者臨床療效及并發癥情況。 結果 觀察組手術時間及住院時間均明顯低于對照組（P<0.05）；觀察組術后發生血清腫的發生率明顯高于對照組（P<0.05）；觀察組術后發生腹股溝區疼痛及神經性疼痛的發生率明顯低于對照組（P<0.05）；觀察組復發率為0，明顯低于對照組的9.76%（P<0.05）。 結論 后入路與前入路無張力疝修補術相比，具有修補效果好、術后恢復快、頑固并發癥少等優點，是一種較佳的無張力疝修補術式。

[關鍵詞]無張力疝修補術；前入路；后入路；并發癥；復發率

[中圖分類號] R656.21 [文獻標識碼] B [文章編號] 2095-0616（2012）22-211-02

Clinical comparative study on tension-free hernioplasty of anterior and posterior approaches on the treatment of adult inguinal hernia

DING Yanzhen

Department of General Surgery，Guoyang County People's Hospital of Anhui Province，Guoyang 233600，China

[Abstract] Objective To investigate the clinical value and superiority of tension-free hernioplasty of posterior approach. Methods 82 cases of inguinal hernia are divided into the observation group and the control group. The patients of observation group were treated with tension-free hernioplasty of posterior approach，while the patients of control group were treated with tension-free hernioplsty of anterior approach. Observations were carried out with clinical efficacies and complications of both groups. Results As for the observation group，its operation time and LOS were both significantly lower than those of the control group （P<0.05）. Its incurrence rate of post-operative seroma was significantly higher than that of the control group （P<0.05）. Its incurrence rate of inguinal region pains and neuropathic pain were significantly lower than that of the control group （P<0.05）. The recurrence rate of the observation group was 0，significantly lower than 9.76% of the control group （P<0.05）. Conclusion Compared with tension-free hernioplasty of anterior approach，the tension-free hernioplsty of posterior approach serves as one good treatment with good repair effects，quick recovery and fewer persistent complications.

[Key words] Tension-free hernioplasty；Anterior approach；Posterior approach；Complications；Recurrence rate

腹股溝疝是臨床常見的一種普外科疾病，是腹股溝發生缺損后腹腔內臟器通過缺損處向體表突出所形成的疝，據有關資料顯示，我國成人腹股溝疝的發生率高達3%～5%，且有逐年遞增趨勢[1]。腹股溝疝已成為嚴重影響我國中老年人健康的一種重要疾病。治療上，隨著醫學技術的進步，無張力疝修補術已廣泛應用于臨床，它較傳統修補術具有復發率低、術后并發癥少等優點，無張力疝修補術的手術入路主要為前入路和后入路兩種，而不同的手術入路，其臨床效果也各不相同。因此，筆者通過分組對比的方法觀察了前、后入路無張力疝修補術治療成人腹股溝疝的臨床效果，并進行了對比分析，旨在為臨床提供一種更為安全、有效的無張力疝修補術治療方案，現報道如下。……