Shouldice术式和改良Millikan网塞法治疗Ⅱ型腹股沟疝的前瞻性研究

目的对比研究Shouldice术式和改良Millikan网塞法治疗Ⅱ型腹股沟疝的临床效果．探讨Ⅱ型疝修补的最佳术式。方法103例Ⅱ型腹股沟疝病例分为Shouldice术式（A，n=57）组和改良Millikan补片（B，n=46）组。对比观察住院期间及术后12个月随访期各相关指标。结果A和B组随访率分别为93％和96．7％。术后疼痛持续时间、伤口感染、阴囊血肿、阴囊水肿和发热的发生率两组无差异（P〉0．05）：两组间切口长度、出血量、手术时间、平均下床活动及住院时间影响术后康复的因素，以及两组间疝复发率、恢复正常步速时间和提重物时间均无差异（P〉0．05）；但是A组平均住院费用明显低于B组（P=0．000）。结论Shouldice术式在治疗Ⅱ型腹股沟疝．不但可以取得与Millikan网塞修补一样的临床效果，而且具有经济上的绝对优势，是治疗腹股沟疝的一项可靠方法。

Prospective study on the effects of the Shouldice's and modified Millikan mesh-plug hernioplasty on repairing type Ⅱ inguinal hernia

Objective To investigate the best means for repairing Ⅱ type Inguinal Hernia. Methods 103 patients Ⅱ with typeinguinal hernia were divided into Shouldice group （group A 57 cases） and Millikan group （group B 46eases）. Patients in group A were treated with Shouldice＇s hernia repair and in group B treated with modified Millikan mesh-plug hernioplasty. The related index of hospitalization period and follow-up period in 12 months after operation were compared between two groups. Results Follow-up rate in group A and B were 93% and 96.7% respectively. There were no difference in the postoperative painful persisted time,wound infection,scrotal hematoma, serotal edema and fever （P〉0.05） between two groups.The incisional length, bleeding valume, operation time, leaving bed time and hospitalization time,hernial recurrence rate, recovering normal walking and lifting heavy things time, hospitalization time were no difference between two groups. But in the average hospitalization cost, the groups A was obviously lower than that group B. Conclusion With shouldice procedure for treating type Ⅱ inguinal hernia, it is not only can get a clinical result seems to Millikan procedure but also it has a absolute superrority economically. It is a reliable method for treatment of ingainal hernia.