CAJ | 학술논문

目的：分析网塞修补术与 Lichtenstein 无张力修补术治疗无张力疝修补术后腹股沟复发疝的临床疗效。方法回顾性分析2009年1月至2014年6月，南京大学医学院附属鼓楼医院收治127例成人无张力疝修补术后腹股沟复发疝患者的临床资料，根据术中复发疝的类型及原有补片周围粘连情况选择不同术式并分组，分别为网塞修补术组（96例）和 Lichtenstein 无张力修补术组（31例），比较二组手术时间、术中出血量、术后疼痛评分、术后住院时间、术后并发症发生率、复发率等。结果二组患者均顺利完成手术并出院，随访时间6～42个月。二组患者手术时间、术中出血量、术后疼痛评分、术后住院时间及并发症比较，差异有统计学意义（t ＝－6．547、－5．472、－8．503、3．509、χ2＝6．714，P ＝0．000、0．000、0．000、0．001、0．010）；二组患者复发率比较，差异无统计学意义（χ2＝0．686，P ＝0．408）。结论网塞修补术较 Lichtenstein 无张力修补术治疗腹股沟复发疝，尤其是再发疝及直疝，有良好的临床疗效，且手术方式简便。
목적：분석망새수보술여 Lichtenstein 무장력수보술치료무장력산수보술후복고구복발산적림상료효。방법회고성분석2009년1월지2014년6월，남경대학의학원부속고루의원수치127례성인무장력산수보술후복고구복발산환자적림상자료，근거술중복발산적류형급원유보편주위점련정황선택불동술식병분조，분별위망새수보술조（96례）화 Lichtenstein 무장력수보술조（31례），비교이조수술시간、술중출혈량、술후동통평분、술후주원시간、술후병발증발생솔、복발솔등。결과이조환자균순리완성수술병출원，수방시간6～42개월。이조환자수술시간、술중출혈량、술후동통평분、술후주원시간급병발증비교，차이유통계학의의（t ＝－6．547、－5．472、－8．503、3．509、χ2＝6．714，P ＝0．000、0．000、0．000、0．001、0．010）；이조환자복발솔비교，차이무통계학의의（χ2＝0．686，P ＝0．408）。결론망새수보술교 Lichtenstein 무장력수보술치료복고구복발산，우기시재발산급직산，유량호적림상료효，차수술방식간편。
Objective To evaluate the clinical value of mesh plug tension-free hernioplasty and Lichtenstein for recurrent inguinal hernia.Methods A total of 1 27 patients with recurrent inguinal hernia were involved in this study and received tension-free inguinal hernia repair from January 2009 to June 201 4 in Gulou Hospital of Nanjing University,with 96 patients in mesh plug tension-free hernioplasty group and 31 patients in Lichtenstein group.The operative time,intraoperative blood loss,postoperative pain scores, postoperative hospital stay,postoperative complications and recurrence rate were compared between the two groups.Results After 6 to 42 months following-up,all the 1 27 operations were successfully completed and released from the hospital.The mesh plug tension-free hernioplasty group had shorter operative time,less blood loss,lower postoperative pain scores,shorter postoperative hospital stay,and lower postoperative complications than those of Lichtenstein group,and the differences were significant(t =-6.547、-5.472、-8.503、3.509、χ2 =6.71 4,P =0.000、0.000、0.000、0.001 、0.01 0).While there was no difference in the rate of recurrence between the two groups (χ2 =0.686,P =0.408).Conclusion Mesh plug tension-free hernioplasty has more advantages in the treatment for recurrent inguinal hernia than Lichtenstein repair.The mesh plug tension-free hernioplasty is an ideal operation for recurrent inguinal hernia,especially in cases of relapsing hernia or direct hernia,for the advantages of simple procedure,minimal invasion and can be popularization.