双层引流在腹股沟嵌顿疝无张力修补术中的应用

目的：探讨腹股沟嵌顿疝无张力修补术放置双层引流的应用价值。方法回顾性分析2008年4月至2013年2月，山东省枣庄市市中区人民医院收治的腹股沟嵌顿疝患者90例，均施行嵌顿疝松解加无张力修补术。将90例患者随机分为观察和对照组，每组各45例。观察组在补片与腱膜之间及腱膜与皮下之间放置引流管。比较二组患者的手术时间、住院时间及并发症发生情况。结果观察组与对照组手术时间分别为（70±8）min和（66±9）min，二组比较差异有统计学意义（t＝2．145，P＝0．035）；观察组与对照组住院时间（7±1）d和（9±1）d，二组比较差异有统计学意义（t＝-7．69，P＝0．000）。观察组疼痛8例（17．8％），对照组7例（15．6％），二组比较差异无统计学意义（χ2＝0．08，P＝0．540）。观察组无阴囊血肿发生，对照组阴囊血肿8例（17．8％），二组比较差异有统计学意义（χ2＝8．78，P＝0．000）。观察组无脂肪液化患者，对照组脂肪液化4例（8．9％），二组比较差异有统计学意义（χ2＝4．19，P＝0．000）。观察组无切口感染患者，对照组感染2例，二组比较差异有统计学意义（χ2＝2．05，P＝0．000）。随访6个月至3年，观察组术后无复发，对照组复发1例（2．2％），二组比较差异无统计学意义（χ2＝1．01，P＝0．051）。结论无张力修补术治疗腹股沟嵌顿疝，术中放置引流管，不影响创面愈合及疝修补效果，并可减少阴囊血肿形成的可能。

Double-layered drainage in tension-free repair of incarcerated inguinal hernia

Objective To evaluate double-layered drainage inincarcerated inguinal hernia tension-free repair.Methods A total of 90 cases of incarcerated inguinal hernia underwent hernia reduction and tension-free repair in Zaozhuang Shizhong People′s Hospital,were retrospectively analyzed.All of them were randomly divided into two groups （45 in each group）.In observation group,drainage tubes were both placed subcutaneously and between mesh and aponeurosis.Operating time,length of stay （LOS）and incidence of recurrence were compared in both groups.Results The operating time in observation group and control group was significantly different （t =2.145,P=0.035）,（70 ±8）minutes and （66 ±9）minutes, respectively.LOS was （7 ±1 ）days in observation group,and （9 ±1 ）days in control group,there was significant difference between two groups （t =-7.69,P =0.000 ）.8 cases （1 7.8%） of pain in observation group and 7 cases （1 5.6%）in control group,no significant difference was found （χ2 =0.08, P=0.540）.None ofscrotal hematoma,fat liquefaction and wound infection were observed in observation group,while there were 8 （1 7.8%）,4（8.9%）,2 （4.4%）cases in control group respectively,it was significantly different between two groups （χ2 =8.78,4.19,2.05,P =0.000,0.000,0.000）.After 6 months to 3 yearsof follow-up,control group had one recurrence （2.2%）,none in observation group,with no significant difference （χ2 =1 .01 ,P =0.051 ）.Conclusion Placement of drainage in incarcerated inguinal hernia tension-free repair would not affect the effect of wound healing and repair,but also reduce the potential risk of scrotal hematoma.