腹股沟疝无张力修补术后并发症分析

目的 分析腹股沟疝无张力修补术后并发症的产生原因，以提高手术成功率。方法 回顾性分析1998年2月到2001年9月我院收治并随访6个月至4年的210例行腹股沟疝无张力修补术患者的临床资料，其中Lichtenstein手术159例，Rutkow手术51例。结果 210例患者中并发局部硬块异物感34例(16．5％)，局部疼痛1个月以上16例(7．6％)，术后复发6例(2．9％)，阴囊水肿5例(2．4％)，精索睾丸炎、睾丸萎缩、射精困难和射精痛及出现对侧疝各3例(1．4％)，局部感染、血肿各2例(1．0％)。结论 腹股沟疝无张力修补术后并发症的产生与精索、疝囊过度剥离，血管神经受损，疝囊未在高位结扎，网片或网塞放置位置不当、未缝合固定或缝合部位不当，网片及网片预裁孔大小不合适，无菌操作不严格，术中止血不彻底以及术前术后对患者其他疾病未作正确处理等因素有关。

Analysis of complication after tensionless repair of inguinal hernia

Objective To analyze the causes of postoperative complication of tensionless repair for inguinal hernia and improve the efficacy of repair.Method We retrospectively studied clinical data of 210 cases(Liechtenstein 159 cases,Rutkow 51 cases)with inguinal hernia who accepted tensionless repair from Feb 1998 to Sep 2001 with a follow-up of 6 months to 4 years.Result The complication listed by the possibility of occurrence descendant is:regional hardness:34 cases (16.5%);local pain last more than one month:16 cases (7.6%),recurrence of hernia:6 cases (2.9%),edema of testis sac:5cases (2.4%);cord testitis/testis atrophy/ejaculation difficulty and ejaculation pain/opposite hernia:3 cases (1.4%),regional infection/hematoma:2 cases (1.0%).Conclusion The occurrence of complication was related to some reasons,such as excessive dissection of cord or hernia sac,vascular or nerve lesion,unsuccessful high location at hernia sac,mismatch of repair pad or its prepared hole,unstrict sterile operation or homeostasis and improper treatment of other diseases.