探讨腹腔镜与开腹无张力疝修补术后切口盐袋压迫的必要性及其对预后的影响。

回顾性分析2014年10月至2017年8月，新疆维吾尔自治区人民医院收治的258例Ⅰ～Ⅲ型的腹股沟疝（inguinal hernia，IH）患者的临床资料，其中行腹腔镜无张力疝修补术患者165例（腹腔镜组），107例术后给予盐袋压迫，行Lichtenstein无张力疝修补术患者93例（开腹组），68例术后给予盐袋压迫，比较2组患者的术后自主下床活动时间、术后第1天疼痛评分、术后切口感染、阴囊或大阴唇水肿、患者的主观感觉等。

2组患者均顺利完成手术，无围手术期死亡，无严重并发症出现，术后均痊愈出院。开腹组术后给予切口盐袋压迫患者术后第1天疼痛评分和阴囊或大阴唇水肿发生率、患者主观感受均优于无盐袋压迫患者，差异均有统计学意义（t=4.639、χ²=6.934、F=3.376，P=0.024、0.008、0.039），而术后自主下床活动时间及术后切口感染发生率无明显差异（t=1.294、χ²=0.463，P=0.121、0.496）。腹腔镜组术后给予盐袋压迫与无盐袋压迫患者术后自主下床活动时间、术后第1天疼痛评分、术后切口感染、阴囊或大阴唇水肿和患者的主观感觉比较，差异无统计学意义（t=1.149、1.396、χ²=0.196、1.739、F=0.370，P=0.217、0.084、0.658、0.187、0.692）。术后给予盐袋压迫患者的比较中，腹腔镜组术后第1天疼痛评分和患者主观感受均优于开腹组，差异有统计学意义（t=3.963、F=4.869，P=0.044、0.009），术后自主下床活动时间及术后切口感染及阴囊或大阴唇水肿发生率无明显差异（t=0.417、χ²=2.251、1.114，P=0.562、0.134、0.291）。

对于开腹无张力疝修补术，术后切口盐袋压迫可减轻患者术后疼痛，有效预防阴囊或大阴唇水肿，提高患者的主观感受，而对于腹腔镜无张力疝修补术，术后盐袋压迫与否对其预后影响不大。

To investigate the necessity of salt bag compression after laparoscopic and open tension-free hernia repair, and to review its influence on prognosis.

The clinical data of 258 patients with typeⅠ-Ⅲ inguinal hernia admitted to the Xinjiang Uygur Autonomous Region People's Hospital from October 2014 to August 2017 were retrospectively analyzed. Of these, 165 cases underwent laparoscopic tension-free hernia repair (laparoscopic group), and 107 cases were treated with salt bag compression; 93 cases underwent Lichtenstein repair (open group), and 68 cases treated with salt bag compression. Compare the two groups of patients with the postoperative ambulation time, postoperative pain score, postoperative incision infection, edema of the scrotum or labia majora, subjective feelings and so on.

There was no perioperative deaths and serious complications during perioperative period in these two groups. In open group, the patients who treated with salt bag compression were superior to those without salt bag compression in postoperative pain score, edema of the scrotum or labia majora and subjective feelings. The difference was statistically significant (t=4.639、χ²=6.934、F=3.376, P=0.024、0.008、0.039). There was no significant difference in the postoperative ambulation time and the incidence of postoperative incision infection (t=1.294、χ²=0.463, P=0.121、0.496). There was no significant difference in above indicators between the patients who treated with salt bag compression and non-salt bag compression in the laparoscopic group (t=1.149、1.396、χ²=0.196、1.739、F=0.370, P=0.217、0.084、0.658、0.187、0.692). Compared to the patients who treated with salt bag compression, laparoscopic group was better in postoperative pain score and subjective feelings than open group. The difference was statistically significant (t=3.963、F=4.869, P=0.044、0.009). However, there was no significant difference in the postoperative ambulation time, postoperative incision infection and edema of the scrotum or labia majora (t=0.417、χ²=2.251、1.114, P=0.562、0.134、0.291).

For open tension-free hernia repair, postoperative salt bag compression can reduce postoperative pain, effectively prevent scrotum or labia majora edema, and improve the patient's subjective feeling. But for laparoscopic tension-free hernia repair, postoperative salt bag compression has little effect on the prognosis.