对比分析三种不同无张力修补术治疗腹股沟疝的临床疗效及安全性。

选取2015年3月至2018年1月恩施州中心医院普外科收治的162例腹股沟疝患者的资料。按照随机数表法分为A组、B组与C组，A组采用Lichtenstein修补术，B组采用疝环充填式疝修补术，C组采用膜前疝修补术，每组各54例。比较分析各组患者的手术时间、术后下床时间、住院时间、视觉模拟评分（VAS）评分以及术后并发症情况。

A组患者的手术时间均长于B组和C组，B组手术时间长于C组，差异均有统计学意义（P<0.05）；A组的住院时间长于C组，差异有统计学意义（P<0.05），A组的住院时间与B组差异则无统计学意义（P>0.05）；A组的下床时间长于B组和C组，B组下床时间低于C组，差异有统计学意义（P<0.05）；术后1 d，3组患者的VAS评分无统计学差异（P>0.05）。术后1个月、6个月，3组患者的VAS评分较前均有所降低，其中B组患者VAS评分显著高于其余2组，差异有统计学意义（P<0.05）。A组与C组间的VAS评分结果相近，差异无统计学意义（P>0.05）；3组间的异物感率不同，B组显著高于A组、C组，差异具有统计学意义（P<0.05）。而A组、C组间的异物感率相近，差异无统计学意义（P>0.05）。3组患者复发率、血清肿发生率、慢性疼痛、外科感染发生率的组间对比差异均无统计学意义（P>0.05）。

由于患者不同个体的差异，应依据病情对腹股沟疝修补术方式进行合理选择，同时结合医疗条件等具体情况，制定最佳的治疗方案。

To compare and analyze the clinical efficacy and safety of three different tension-free repair for inguinal hernia.

From March 2015 to January 2018, 162 patients with inguinal hernia admitted to the general surgery department of our hospital were randomly divided into the group A, the group B and the group C. Group A was treated with Lichtenstein repair, group B with Rutkow repair, and group C with Kugel repair, with 54 patients in each group. The operation time, the postoperative time out of bed, the hospitalization time, the visual analogue score (VAS), and the postoperative complications of patients in each group were statistically analyzed.

The operation time in group A was longer than that in group B and C, while the operation time in group B was longer than that in group C, with statistical differences (P<0.05). The length of hospital stay in group A was longer than that in group C, with statistical differences (P<0.05), but there was no statistically significant difference between group A and group B (P>0.05). The time of getting out of bed in group A was longer than that in group B and C, and the time of getting out of bed in group B was lower than that in group C, with statistical differences (P<0.05). There was no significant difference in the score of VAS between the three groups 1 day after surgery (P>0.05). At 1 month and 6 months after surgery, the scores of VAS in the patients in the three groups were lower than those before, and the scores of VAS in the group B were significantly higher than those in the other two groups, with statistical differences (P<0.05). The score of VAS between the group A and the group C was similar, and the results were not statistically different (P>0.05). The foreign body susceptibility was different among the three groups, and the group B was significantly higher than the group A and C, with statistical differences (P<0.05). The rate of foreign body susceptibility was similar between the group A and C, and the results were not statistically different (P>0.05). There were no significant differences in recurrence rate, incidence of seroma, incidence of chronic pain and incidence of surgical infection among the three groups (P>0.05).

Due to the individual differences of patients, no one operation can perfectly cope with all patients. Therefore, it is necessary to make a reasonable choice of inguinal hernia repair according to the different cases, and to make the best treatment plan according to the specific conditions of patients' conditions and medical conditions.