摘要
目的:比较三种开放式无张力修补术式(Lichtenstein,Rutkow,PHS)的疗效,探讨复发原因及复发疝的治疗方法。方法:分别采用上述三法治疗腹股沟疝病人710例(759例次),比较各组手术时间、总费用、下床活动时间、住院时间及近远期并发症。对引起术后复发的各种相关因素进行分析。结果:平均随访率80.1%。Lichtenstein组与Rutkow组平均手术时间显著低于PHS组。平均住院费用Lichtenstein组明显低于Rutkow与PHS组。复发率、近期并发症、下床活动时间、住院时间及慢性疼痛三组无明显差异。Ⅲ型及Ⅳ型疝的术后复发率显著高于Ⅰ型及Ⅱ型疝病人。结论:我国疝学会分型中的Ⅲ及Ⅳ型疝术后更易复发,而对于复发疝的治疗应遵循"个体化"原则。三种术式均具有复发率低,疼痛轻、创伤小、异物感轻的优点,其中Lichtenstein术更具有手术时间短、费用低廉的优势。
Objective To compare the efficacy of 3 different types of open tension-free hernioplasty （Lichtenstein, Rutkow and PHS）, as well as their rate of recurrence. Methods The clinical data from 710 patients （759 hernias） with inguinal hernia undergoing the Lichtenstein, Rutkow or PHS procedure were retrospectively analyzed. The operating time, total expenses, independent walking time, average hospital stay, short-term and long-term complications were compared among the groups. The potential risk factors correlated with hernia recurrence were also analyzed. Results The follow-up rate was 80.1%. The operating time was significantly shorter in the Rutkow and Lichtenstein groups. The average hospital expense was significantly lower in the Liehtenstein group than in the other two groups. There was no difference in recurrence rate, short-term complications, independent walking time, average hospital stay and postoperative chronic pain among these 3 groups. The recurrence rate in type Ⅲ and type Ⅳ hernia patients was significantly higher than that in type I or Ⅱ hernia patients. Conclusions Recurrence occurred more frequently in types Ⅲ and Ⅳ. Treatment of recurrent hernias should be planned basing upon ＂individualized standards＂. All of the 3 hernioplasty procedures may achieve good effects, characterized with low recurrence rate, minor postoperative pain, quick recovery, short hospital stay and low post-operative complications. In addition, in terms of operating time and cost, the Liehtenstein procedure overtakes the Rutkow and PHS.
出处
《外科理论与实践》
2008年第6期528-530,共3页
Journal of Surgery Concepts & Practice
关键词
疝
腹股沟
疝修补术
复发
对比研究
Hernia, inguinal
Hernia repair, Recurrence
Comparative study
作者简介
通讯作者：王坚，dr_wangjian@yahoo．com．cn
