CAJ | 학술논문

目的：探讨传统缝合法与无张力修补法治疗成人脐疝的临床体会。方法回顾性分析58例成人脐疝患者的临床资料，其中15例行传统缝合法修补（传统缝合组），43例行无张力修补术（无张力修补组），应用SPSS 13．0软件包进行统计分析，组间疗效比较采用t检验，组间并发症比较采用χ2检验，P＜0．05为差异有统计学意义。结果传统缝合组和无张力修补组，平均手术时间分别为48．5 min和62．3 min，组间差异有统计学意义（t＝2．058， P＜0．05）；术后平均住院时间分别为4．5 d和3．8 d，组间差异无统计学意义（t＝1．137， P＞0．05）。无张力修补组住院费用明显高于传统缝合组（t＝3．465， P＝0．001）。术后随访4～54个月，随访率72．4％。术后并发症两组无差异，术后皮下积液仅无张力修补组1例；术后慢性疼痛两组各有1例；术后切口感染和疝复发两组均未出现。结论传统缝合法和无张力修补法治疗脐疝均取得了良好的临床效果，但各自的适应证不同，需要个体化选择。
목적：탐토전통봉합법여무장력수보법치료성인제산적림상체회。방법회고성분석58례성인제산환자적림상자료，기중15례행전통봉합법수보（전통봉합조），43례행무장력수보술（무장력수보조），응용SPSS 13．0연건포진행통계분석，조간료효비교채용t검험，조간병발증비교채용χ2검험，P＜0．05위차이유통계학의의。결과전통봉합조화무장력수보조，평균수술시간분별위48．5 min화62．3 min，조간차이유통계학의의（t＝2．058， P＜0．05）；술후평균주원시간분별위4．5 d화3．8 d，조간차이무통계학의의（t＝1．137， P＞0．05）。무장력수보조주원비용명현고우전통봉합조（t＝3．465， P＝0．001）。술후수방4～54개월，수방솔72．4％。술후병발증량조무차이，술후피하적액부무장력수보조1례；술후만성동통량조각유1례；술후절구감염화산복발량조균미출현。결론전통봉합법화무장력수보법치료제산균취득료량호적림상효과，단각자적괄응증불동，수요개체화선택。
Objective To investigate the clinical application of traditional suture and tension-free repair in treating adult umbilical hernia .Methods Clinical data of 58 patients with adult umbilical hernia were analyzed retrospectively .This series of patients included 15 patients who underwent traditional suture repair ( traditional suture group ) and 43 patients who underwent tension-free repair ( tension-free repair group).Statistical analysis was made using SPSS 13.0 software.Curative effect was compared between the two groups using Student ’ st test, and complications were compared between the two groups using the chi-square test.P<0.05 was considered statistically significant .Results Mean operation time was 48.5 minutes and 62.3 minutes in the conventional suture group and the tension-free repair group , respectively (t=2.058, P<0.05), whereas mean postoperative hospital stay was 4.5 days and 3.8 days respectively, with no differences between the 2 groups (t=1.137, P>0.05).Hospitalization expenses of the tension-free repair group was higher than that of the traditional suture group (t=3.465, P=0.001).Follow-up time (72.4%) ranged from 4 to 54 months.Postoperative complications between the two groups showed no significant difference .There was one case of subcutaneous fluid in the tension-free repair group , one case of postoperative chronic pain in each group , and no postoperative wound infection and hernia recurrence in both groups.Conclusion Good clinical outcomes were achieved by traditional suture or tension-free repair in treating adult umbilical hernia;however different indications should be followed for individualized treatment .