严海兰

[摘要] 目的 探讨成人疝气应用无张力疝修补术治疗的临床效果。 方法 选取本院2014年10月～2016年10月成人疝气患者118例，59例患者采用传统修补术治疗为对照组，59例患者采用无张力疝修补术治疗为观察组，于治疗前后给予患者疼痛评分，比较两组患者的手术情况、并发症情况。 结果 观察组患者手术时间（43.2±5.6）min、术中出血量（27.3±4.0）mL、术后住院时间（5.0±0.8）d少于对照组（68.7±4.8）min、（35.8±3.1）mL、（7.7±0.9）d。观察组患者下床活动时间（16.4±2.7）h早于对照组（134.6±11.8）h。观察组患者疼痛评分（1.1±0.2）分、并发症发生率（1.7%）低于对照组（1.8±0.3）分、13.6%。差异均有统计学意义（P<0.05）。 结论 成人疝气应用无张力疝修补术的治疗效果显著，且安全性高，值得临床推广使用。

[关键词] 成人疝气；无张力疝修补术；传统修补术；并发症

[中图分类号] R656.2 [文献标识码] A [文章编号] 2095-0616（2017）11-211-04

Clinical research on application of tension-free hernioplasty in treatment of adult hernia

YAN Hailan

Jiangsu Civil Administration Rehabilitation Hospital， Nanjing 210003， China

[Abstract] Objective To explore clinical effect of tension-free hernioplasty in treatment of adult hernia. Methods 118 patients with adult hernia in our hospital from October 2014 to October 2016 were selected. 59 patients were given traditional hernioplasty and they were set as the control group. 59 patients were given tension-free hernioplasty and they were set as the observation group. Pain before and after treatment of patients were evaluated. Operation and complications between two groups were compared. Results Operation time， intraoperative blood loss and postoperative hospitalization stay of patients in the observation group were respectively （43.2±5.6）min， （27.3±4.0）mL and （5.0±0.8）d， less than those of the control group （68.7±4.8）min， （35.8±3.1）mL and （7.7±0.9）d. Time of leaving time of theobservation group was （16.4±2.7）h， earlier than that of the control group （134.6±11.8）h. Pain score and complication rate of the observation group were respectively （1.1±0.2）points and 1.7%， lower than those of the control group （1.8±0.3） points and 13.6%. Differences were statistically significant （P<0.05）. Conclusion Application of tension-free hernioplasty in treatment of adult hernia has a significant treatment effect and high safety， which is worthy of clinical promotion and application.

[Key words] Adult hernia； Tension-free hernioplasty； Traditional hernioplasty； Complication

疝氣是临床外科的一种常见病症，成年人以腹股沟斜疝最为常见[1-2]，手术治疗是成人疝气的常用治疗手段，手术方式多为疝修补术，但不同疝修补术取得的临床疗效是明显不同的[3-4]，传统疝修补术需要将不同解剖组织和层次实施机械缝合，手术操作是非常复杂的，术后造成的张力比较明显，易发生撕裂，会延长患者的恢复时间，术后复发率较高，可高达20%～30%，会严重影响到患者的生活质量[5-6]。如何确保疝修补术疗效的同时，提高手术安全性，成为了临床医生关注的热点问题。此次研究对59例成人疝气患者实施无张力疝修补术治疗，效果显著，现报道如下。

1 资料与方法

1.1 一般资料

2014年10月～2016年10月到本院就诊的成人疝气患者118例，排除患有器质性疾病、血液系统疾病、免疫系统疾病、精神性疾病者。采用随机数字表法分为两组，对照组患者59例，男38例，女21例，年龄为25～67岁，平均（46.8±10.1）岁，病程为2～17年，平均（10.2±2.3）年，发病部位：单侧发病49例、双侧发病10例。……