运用改良网塞补片行腹膜前间隙腹股沟疝修补的前瞻性对照研究

目的 评价改变外形的网塞补片在腹股沟疝的腹膜前间隙修补中的安全性和有效性.方法 对2008年12月至2010年5月收治的134例原发腹股沟疝患者,138个疝,分2组,实验组67例(70侧)疝,采用北京天助畅运的网塞补片行Rutkow术,对照组67例(68侧)疝,采用外形改良的北京天助畅运网塞补片对腹股沟疝进行腹膜前间隙的修补.结果 127例得到随访,随访率95%.随访时间2～18个月,平均9.2个月.其中实验组随访64例,平均随访(9±4)个月;对照组随访63例,平均随访(9±5)个月.两组手术时间比较(P=0.080)、术中出血量比较(P=0.116)、术后住院时间比较(P=0.318)、术后总并发症比较(P=0.697)差异无统计学意义;术后实验组疼痛要轻于对照组,术后第2天疼痛分数差异有统计学意义(P=0.048).两组在随访期内均无复发.结论 运用改良的网塞补片行腹膜前间隙修补治疗腹股沟疝与传统的一样安全有效,在舒适性上更具优势.

Tension-free repair in the preperitoneal space using modified surgical mesh for inguinal hernia: a prospective randomized study

Objective To summarize the experience of tension-free repair for inguinal hernia in the preperitoneal space using modified surgical mesh. Methods From Dec 2008 to May 2010, 134 cases with 138 reducible primary inguinal hernia were randomly divided into two groups. Sixty-seven patients (70 hernias) in the study group underwent tension-free repair in the preperitoneal space by modified surgical mesh, while the control group (67 cases, 68 hernias) underwent Rutkow's herniorrhaphy by surgical mesh.Results Postoperatively 127 cases (95%) were followed up from 2 to 18 months with an average of 9. 2months[64 cases of the test group were followed up with an average of(9 ±4) months, 63 cases of the control group followed up with an average of (9 ± 5 ) months]. There was no recurrence. No significant differences were found between the two groups in the operation time (P = 0. 697), blood loss (P = 0. 318 ),hospital stay (P = 0. 116) and total postoperative complications (P = 0. 080). The visual analogue scale of the study group was lower than the scale of the control group ( P = 0. 048 ). Conclusions Modified surgical mesh is more comfortable in the treatment of inguinal hernia with tension-free repair in the preperitoneal space with a comparative result to Rutkow's herniorrhaphy by surgical mesh.