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中华疝和腹壁外科杂志(电子版)

中华疝和腹壁外科杂志(电子版) ›› 2023, Vol. 17 ›› Issue (02) : 155 -159. doi: 10.3877/cma.j.issn.1674-392X.2023.02.008

临床论著

开放式腹膜前间隙补片修补对腹股沟嵌顿或绞窄性疝的疗效
廖巧1,†(), 周新竹2   
  1. 1. 210306　上海市第六人民医院普外科
    2. 417599　湖南省冷江市人民医院内科
  • 收稿日期:2022-10-27 出版日期:2023-04-18
  • 通信作者: 廖巧
  • 基金资助:
    上海市自然科学基金项目(18ZW1433500)

Effect of open preperitoneal space patch repair on incarcerated or strangulated inguinal hernia

Qiao Liao1,†(), Xinzhu Zhou2   

  1. 1. Department of General Surgery, Shanghai Sixth People's Hospital, Shanghai 210306, China
    2. Department of Internal Medicine, People's Hospital of Lengjiang City, Hunan Province, Lengjiang 417599, China
  • Received:2022-10-27 Published:2023-04-18
  • Corresponding author: Qiao Liao
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廖巧, 周新竹. 开放式腹膜前间隙补片修补对腹股沟嵌顿或绞窄性疝的疗效[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(02): 155-159.

Qiao Liao, Xinzhu Zhou. Effect of open preperitoneal space patch repair on incarcerated or strangulated inguinal hernia[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2023, 17(02): 155-159.

目的

探讨开放式腹膜前间隙补片修补术对腹股沟嵌顿或绞窄性疝的治疗效果。

方法

回顾性分析2020年1月至2021年12月在上海市第六人民医院普外科接受腹股沟疝手术治疗的82例患者的资料。依据患者手术过程中是否采用补片修补进行分组：41例未使用补片修补的患者作为对照组，41例采用补片修补的患者作为观察组。对比2组手术相关指标（手术耗时、失血量、术后下床活动时间、总住院时间）、疼痛情况指标（视觉模拟评分法评估术后1、6、12 h及出院时的疼痛严重程度）、术后并发症指标（切口感染、阴囊水肿、伤口血肿、肺部感染、麻痹性肠梗阻）、术后半年的复发情况。

结果

2组患者的手术耗时、失血量、术后下床活动时间、总住院时间差异均无统计学意义（P>0.05）。2组患者术后1、6、12 h及出院时的疼痛严重程度差异均无统计学意义（P>0.05）。2组术后各类并发症差异无统计学意义（P>0.05）。术后半年复发率观察组为0（0/41）低于对照组17.07%（7/41）（χ2=5.623，P<0.05）。

结论

在腹股沟嵌顿或绞窄性疝急诊手术采用开放式腹膜前间隙补片修补术，治疗效果良好，具有较好的安全性，可以防止疝复发。

关键词: 腹膜前间隙, 疝，腹股沟, 嵌顿疝, 绞窄性疝, 疝修补术
Objective

To investigate the clinical effect of open preperitoneal space patch repair on an incarcerated or strangulated inguinal hernia.

Methods

The data of 82 patients with inguinal hernias who underwent surgery in the Department of General Surgery of our Hospital from January 2020 to December 2021 were analyzed retrospectively. Patients were divided into groups according to whether patch repair was used during the operation: 41 patients who did not use patch repair were in the control group, and 41 patients who used patch repair were in the observation group. The operation related indicators (operation time, blood loss, postoperative ambulation time, total hospital stay), pain indicators (1, 6, 12 h after operation, pain severity at discharge. Visual analogue scale), postoperative complications indicators (incision infection, scrotal edema, wound hematoma, lung infection, paralytic intestinal obstruction) and recurrence of half a year after operation were compared between the two groups.

Results

There was no significant difference in operation time, blood loss, postoperative ambulation time and total hospital stay between the two groups (P>0.05). There was no significant difference in the severity of pain between the two groups at 1, 6, 12 h after operation and at discharge (P>0.05). There was no significant difference in postoperative complications between the two groups (P>0.05). The recurrence rate of patients in the observation group half a year after operation was lower than that of patients in the control group [0 vs 17.07% (7/41)] (χ2=5.623, P<0.05).

Conclusion

In the emergency surgical treatment of patients with incarcerated or strangulated inguinal hernias, the use of open preperitoneal patch repair can achieve good therapeutic effect, have good safety, and prevent the recurrence of the patient's condition.

Key words: Preperitoneal space, Hernia, inguinal, Incarcerated hernia, Strangulated hernia, Herniorrhaphy
表1 2组患者一般资料比较[例（%）]
组别 例数 性别 年龄(岁,±s) 体质量指数(kg/m2,±s) 病发后就诊时间(h,±s) 美国麻醉医师协会分级
男性 女性 Ⅰ Ⅱ
对照组 41 28(68.29) 13(31.71) 66.13±4.37 23.42±2.76 4.32±1.63 29(70.73) 12(29.27)
观察组 41 30(73.17) 11(26.83) 67.38±5.01 23.56±2.88 4.28±1.77 31(75.61) 10(24.39)
χ2/t值   0.236 -1.204 -0.225 0.106 0.248
P值   0.627 0.232 0.823 0.915 0.618
组别 例数 病变位置 嵌顿疝 绞窄性疝 疝分类 高血压 糖尿病 高血脂
左侧 右侧 斜疝 直疝 是 否 是 否 是 否
对照组 41 15(36.59) 26(63.41) 33(80.49) 8(19.51) 23(56.10) 18(43.90) 18(43.90) 23(56.10) 14(34.15) 27(65.85) 15(36.59) 26(63.41)
观察组 41 13(31.71) 28(68.29) 34(82.93) 7(17.07) 25(60.98) 16(39.02) 20(48.78) 21(51.22) 11(26.83) 30(73.17) 17(41.46) 24(58.54)
χ2值   0.217 0.082 0.201 0.196 0.518 0.901
P值   0.641 0.775 0.654 0.658 0.472 0.342
表2 2组患者手术情况相关指标（±s）
组别 例数 手术耗时(min) 失血量(ml) 术后下床活动时间(h) 总住院时间(d)
对照组 41 68.06±10.36 50.33±12.36 11.45±2.36 5.93±1.38
观察组 41 70.45±10.78 49.35±14.35 11.23±1.36 6.05±1.32
t值   -1.024 0.331 0.517 -0.402
P值   0.309 0.741 0.606 0.688
表3 2组患者术后不同时间疼痛视觉模拟评分（分，±s）
组别 例数 术后1 h 术后6 h 术后12 h 出院时
对照组 41 3.99±0.54 3.02±0.36 2.55±0.22 1.15±0.24
观察组 41 4.01±0.56 3.04±0.45 2.51±0.26 1.20±0.23
t值   -0.165 -0.222 0.752 -0.963
P值   0.870 0.825 0.454 0.338
表4 2组患者术后并发症情况[例（%）]
组别 例数 切口感染 阴囊水肿 伤口血肿 肺部感染 麻痹性肠梗阻 合计
对照组 41 1(2.44) 1(2.44) 1(2.44) 0 0 3(7.32)
观察组 41 1(2.44) 0 1(2.44) 1(2.44) 1(2.44) 4(9.76)
χ2值             0.000
P值             1.000
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