分型选择开放式无张力修补术治疗腹股沟疝134例临床效果观察

目的探讨腹股沟疝分型选择无张力修补术及其临床疗效。方法将收治的134例腹股沟疝按Gilbert和Rutkow分型标准分为：Ⅰ型22例,Ⅱ型34例,Ⅲ型40例,Ⅳ-Ⅴ型30例,Ⅵ型2例,Ⅶ型6例。将Ⅰ型、Ⅱ型划为A组（56例）,Ⅲ型划为B组（40例）,Ⅳ-Ⅶ型划为C组（38例）。三组分别采用Lichtenstein手术、Rutkow手术和腹膜前修补手术。比较三组间住院费用、住院时间、手术时间及并发症等。结果 134例腹股沟疝患者均顺利完成手术,围手术期无死亡病例。三组间A组采用Lichtenstin手术,住院费用明显低于其他两组（P〈0.05）,住院时间,手术时间,术后并发症等各组间差异无统计学意义（P＞0.05）。结论腹股沟疝应根据术中分型来选择无张力修补术,可避免盲选术式,减少并发症,降低医疗费用,实现规范化、个体化治疗。

Clinical effect of type selection of open tension-free hernia repair on inguinal hernia

Objective To investigate effect of type selection of open tension-free hernia repair on inguinal hernia.Methods 134patients with inguinal hernia wereⅠtype（22cases）,typeⅡ（34 cases）,Ⅲ type（40 cases）,Ⅳ-Ⅴtype（30 cases）,Ⅵtype（2cases）and Ⅶ type（6cases）.The typeⅠ,Ⅱtype designated as Group A.Ⅲ type designated as group B.Ⅳ-Ⅶ type designated as Group C.Group A,B and C were treated with Lichtenstein surgery,Rutkow surgery and preperitoneal repair.The hospitalization costs,length of stay,surgical time and complications were obseved.Results 134 cases of inguinal hernia patients were successfully operated.The hospital costs of Group A was significantly lower than that of the other two groups（P〈0.05）.The hospital stay,operative time,postoperative complications of the tree groups were no statistically significant differences.Conclusion Inguinal hernia surgery should be based on carve-type tension-free repair to avoid blind election procedure,reduce complications and medical costs.