无张力疝修补术与传统疝修补术治疗腹股沟嵌顿疝的疗效比较

目的：探讨无张力疝修补术与传统疝修补术治疗腹股沟嵌顿疝的疗效比较。方法选取腹股沟嵌顿疝患者84例，采用随机数字表将纳入患者分为观察组（ n＝42例）和对照组（ n＝42例），分别采用无张力疝修补术和传统疝修补术。观察并比较两组患者的手术时间、术中出血量、术后下床活动时间、术后镇痛率、术后住院时间、术中术后并发症和复发率。结果观察组手术时间、术后下床活动时间、术后镇痛率和术后住院时间[（45．7±10．3） min、（28．7±7．5） h、14．29％、（4．13±0．97） d]均明显少于对照组[（53．9±11．7）min、（41．5±10．3）h、35．71％、（6．07±1．04）d]（t或χ^2＝2．15、2．39、5．14、2．41，P＜0．05或P＜0．01）。两组术中出血量差异无统计学意义（P＞0．05）。观察组和对照组术后分别出现并发症3例和10例，观察组术后并发症发生率明显低于对照组（χ^2＝4．46，P＜0．05）。术后随访6～67个月，观察组术后未出现复发，对照组术后出现复发6例，观察组术后复发率明显低于对照组（χ^2＝4．49，P＜0．05）。结论无张力疝修补术治疗腹股沟嵌顿疝的疗效确切，具有手术时间短、术后下床活动时间早、术后镇痛率低、术后住院时间短、并发症少、复发率低等优点，可逐渐取代传统疝修补术成为治疗无肠管坏死腹股沟嵌顿疝的首选术式。

Comparison of curative effects of tension-free herniorrhaphy for phrase I and traditional herniorrhaphy on the treatment of incarcerated hernia

Objective To discuss curative effects of tension-free herniorrhaphy for phrase I and traditional herniorrhaphy on the treatment of incarcerated hernia.Methods 84 cases with incarcerated hernia were selected and divided into the observation group （ n=42 ） and control group （ n=42 ） by random number table, who were given tension-free herniorrhaphy for phrase I and traditional herniorrhaphy respectively.The operation time, amount of bleeding,out-of-bed activity time,analgesic rate and length of stay （ LOS） after the operation,and complication and reoccurrence rates during and after the medical treatment were observed and compared.Results The operation time, out-of-bed activity time,analgesic rate and length of stay （ LOS） after the operation of patients in the observation group[（45.7 ±10.3） min,（28.7 ±7.5） h,14.29%,（4.13 ±0.97） d] were all much shorter than those in the control group[（53.9 ±11.7）min,（41.5 ±10.3）h,35.71%,（6.07 ±1.04）d]（t or χ^2 =2.15,2.39,5.14,2.41, P〈0.05 or P〈0.01）.After comparing the amount of bleeding of patients in the two groups during the operation,no obvious statistical differences appeared （P〉0.05）.3 and 10 cases of complication appeared in the observation group and control group after the operation respectively.The occurrence rate of complication in the observation group after the operation was much lower than that in the control group （χ^2 =4.46,P〈0.05）.Following up for 6 to 67 months, no reoccurrence appeared in the observation group after the operation,while 6 cases of which appeared in the control group.And the postoperative reoccurrence rate of patients in the observation group was much lower than that in the control group （χ^2 =4.49,P〈0.05）.Conclusion Tension-free herniorrhaphy for phrase I has confirmative curative effect on incarcerated hernia,with the following advantages like short operation time and out-of-bed activity time after the operation,low postoperative analgesic rate,short LOS,little complication,