Hesselbach三角前入路修补股疝临床研究

目的探讨前入路由Hesselbach三角进入途径修补股疝临床意义。 方法回顾性分析西南交通大学附属医院2012年1月至2016年12月收治的40例股疝患者，采用前入路手术治疗，分为经腹股沟韧带下方股环处进行修补法（A组）和由Hesselbach三角进入修补法（B组），各20例，分别对手术时间、住院时间、术中出血量、术中发现隐匿疝、术中使用补片、嵌顿疝内容物及其处理、早期并发症等临床资料进行对比。 结果A、B两组在手术时间、住院时间、术中出血量、肠切除、网膜切除、术中发现隐匿疝、术中使用补片、术后再发、术后切口感染、血清肿、尿潴留等对比差异无统计学意义（t=1.063、0.117、0.274，χ²=0.257、0.305、3.243、0.173、2.105、0.360、0.173、0.229，P=0.294、0.907、0.781、0.612、0.581、0.072、0.677、0.147、0.548、0.677、0.633）；而A组在术中另做切口探查、术后异物感、下肢肌间静脉血栓发生率均明显高于B组，差异均有统计学意义（χ²=9.794、7.025、5.625，P=0.002、0.008、0.018）。 结论前入路由腹股沟韧带上方经Hesselbach三角进入修补股疝是安全有效的手术技术。

Clinical study on the repair of femoral hernia by the Hesselbach triangle entry route

ObjectiveTo explore the clinical significance of Hesselbach triangle entry approach to the repair of femoral hernia. MethodsA retrospective analysis of forty patients with femoral hernia from January 2012 to December 2016 in the Affiliated Hospital of Southwest Jiaotong University was carried out. The anterior surgical approach was used to repair the femoral ring below the inguinal ligament in group A, and above the Hesselbach triangle for repair in group B, with 20 cases in each group respectively. The operation time, hospitalization time, intraoperative bleeding, intraoperative discovery of concealed sputum, intraoperative use of patches, incarcerated sputum content and its treatment, early complications and other clinical data were collected and compared. ResultsThere were no significant differences in operation time, hospitalization time, intraoperative blood loss, intestinal resection, omental resection, intraoperative occult sputum, intraoperative patch, postoperative recurrence, postoperative incision infection, seroma and retention between two groups (t=1.063, 0.117, 0.274, χ²=0.257, 0.305, 3.243, 0.173, 2.105, 0.360, 0.173, 0.229, P=0.294, 0.907, 0.781, 0.612, 0.581, 0.072, 0.677, 0.147, 0.548, 0.677, 0.633). In group A, the incidence of incision exploration, postoperative foreign body sensation, and lower extremity intermuscular venous thrombosis were significantly higher than those in group B, and the differences were statistically significant (χ²=9.794, 7.025, 5.625, P=0.002, 0.008, 0.018). ConclusionIt is safe and effective for the repair of the femoral hernia through the Hesselbach triangle entry into the inguinal ligament.