王新平　陈进红　张华　于鸣　张伟　梁晓

[摘要] 目的 比较开放式腹膜前间隙与疝环充填式无张力疝修补术治疗成年人腹股沟疝的疗效。 方法 回顾性分析2012年1月～2014年12月收治的95例腹股沟疝患者的临床资料。按照手术方式分为两组。A组34例，采用腹膜前间隙无张力疝修补术，B组61例，采用疝环充填式无张力疝修补术，比较两组治疗后的效果以及术后并发症。 结果 两组平均住院日差异无统计学意义；术后最早下地活动时间A组明显短于B组，术后24h视觉模拟评分法疼痛评分A组小于B组，差异均有统计学意义。两组患者随访4～36个月，均无一例复发。两组术后并发症发生率差异无统计学意义。A组在术后局部疼痛不适、慢性疼痛等方面优于B组。 结论 两种方法对腹股沟疝修补都具有良好的疗效，但是腹膜前间隙无张力疝修补术后局部舒适度更佳，手术更安全。

[关键词] 疝；腹股沟；疝环充填式无张力腹股沟疝修补术；腹膜前间隙无张力腹股沟疝修补术

[中图分类号] R656.21 [文献标识码] B [文章编号] 2095-0616（2015）24-178-04

[Abstract] Objective To compare the effect on open preperitoneal space and filling hernia ring of tension-free inguinal herniorrhaphy in adult patients with inguinal hernia. Methods 95 patients inguinal hernia of clinical data， who were received and treated from January 2012 to December 2014， were retrospectively analyzed and were divided into two groups according to operative methods. 34 cases in A group were treated with preperitoneal space tension-free inguinal herniorrhaphy， and 61 cases in B group were treated with preperitoneal space and filling hernia ring tension-free inguinal herniorrhaphy. To compare the treatment effect and postoperative complications between the two groups. Results The differences of the average hospitalization day and operation time between the two groups were no statistical significance. The most early activity time of leave a sickbed after operation in A group was obviously shorter than which in B group， the pain score according to visual analogue scale after 24h operation in A group was less than which in B group， the differences were statistical significance. Patients of the two groups were followed-up 4 to 36 months， without recurrence. The differences of the incidence rate of complication after operation was no statistical significance compared with the two groups. The local pain and discomfort， the chronic pain etc. after operation in A group were better than which in B group. Conclusion The two methods of inguinal herniorrhaphy all have better treatment effect， while preperitoneal space tension-free inguinal herniorrhaphy has much better local degree of comfort， has much safety on surgical operation.

[Key words] Hernia； Inguinal； Filling hernia ring tension-free inguinal herniorrhaphy； Preperitoneal space tension-free inguinal herniorrhaphy

腹股沟疝由于其发病率高、复杂多样以及社会-经济影响，一直是外科医生最大的挑战之一。从2014年6月沈阳中华医学会第八届全国疝和腹壁外科学术研讨会[1]获悉，中国每年约有300万新发的腹股沟疝患者，以及50万例以上的其他各类疝。其中腹股沟疝的发病率约为3‰～5‰，而老年男性的发病率显著增高，可达11.6‰。成年人一旦腹股沟疝形成，自行愈合的可能很小，手术仍然是目前治愈腹股沟疝的唯一方法[2-3]。……