二次内环重建全腹股沟疝修补术的临床应用

目的：探讨二次内环重建全腹股沟疝修补的临床效果。方法：回顾分析2007年1月～2010年1月收治的120例非嵌顿和绞窄型的腹股沟疝患者的临床资料。75例行二次内环重建全腹股沟疝修补的患者为二次内环重建组，45例行疝环充填式修补的患者为Plug—mesh组。对比2组患者术中情况、术后并发症以及恢复情况。结果：两组在平均手术时间、阴囊血肿、切口下积血／液、局部异物感、每例补片材料消耗及复发例数方面比较，差异有统计学意义（P〈0．05）；术后疼痛感方面Plug—mesh组总体明显高于二次内环重建组（P=0．001）；两组患者在平均下床活动时间、平均住院时间、切口裂开及感染、瘘道形成方面比较，差异均无统计学意义（P〉0．05）。术后随访1—4a，二次内环重建组无复发。结论：二次内环重建能完全修补全腹股沟疝，从应用生物力学理论和应用方法学上，符合全腹股沟肌耻骨孔疝修补。

Clinical Application of Secondary Reconstruction for the Annulus Inguinalis Profundus Entire My- opectineal Orifice Repair Unguinal Hernia

Objective：To investigate the clinical effect of secondary internal ring reconstruction for the annulus inguinalis profundus entire myopectineal orifice repair unguinal hernia. Methods：Clinical data of 120 patients admitted to non - incarcerated and strangulated inguinal hernia from Jan. 2007 to Jan. 2010 were retro- spectively analyzed. Among them, 75 cases underwent secondary reconstruction of the annulus inguinalis profundus entire myopectineal orifice repair unguinal hernia , 45 cases with plug - mesh tension - free hernia repair. Then intraoperative results, postoperative complications, and rehabilitated results of patients in 2 groups were compared. Results：The mean operative time and scrotal hematoma wound hematoma or under the （liquid） , local foreign body sensation , consumption of materials per case and recurrence in 2 groups were significant（P 〈 0.05 ）. Plug - mesh group was significantly higher than the secondary reconstruction of the annulus inguinalis profundus in the postoperative pain（ P = 0.001 ）. The mean time to ambulation and hospital stay, wound dehiscence, infection and fistula formation in 2 groups had no significant difference （ P 〉 0.05 ）. Conclusions： Sec- ondary reconstruction of the annulus inguinalis profundus can fully meet the purpose of repair inguinal hernia of myopectineal orifice from the application of bio - mechanical theory and application of methodology.