作　　者： (陈佳栋）; (孙颢）; (高友福）; (米娜瓦尔）;

机构地区： 上海市静安区中心医院华山医院静安分院普外科,上海200040

出　　处： 《中国现代手术学杂志》 2017年第3期191-193,共3页

摘　　要： 目的探讨腹股沟疝手术中改良Kugel修补术与Lichtenstein修补术的临床选择。方法回顾性分析2014年2月~2015年8月149例腹股沟疝患者临床资料,其中Ⅰ型2例,Ⅱ型12例,Ⅲ型119例,Ⅳ型16例;直疝50例,斜疝99例;均采用改良Kugel修补术(改良Kugel组)。以同期行Lichtenstein修补术治疗的171例腹股沟疝患者(Lichtenstein组)作为对照,其中Ⅰ型4例,Ⅱ型13例,Ⅲ型141例,Ⅳ型13例;直疝60例,斜疝111例。结果两组患者均顺利完成手术。改良Kugel组手术时间较Lichtenstein组短,差异有统计学意义(P<0.05);而两组术后补片感染率、阴囊水肿率比较均无统计学差异(P>0.05)。所有患者均获随访,随访时间平均13.5(6~24)个月。改良Kugel组与Lichtenstein组腹肌沟疝复发率分别为0.67%和4.68%,均为Ⅲ、Ⅳ型患者,组间比较差异有统计学意义(P<0.05)。结论对于Ⅰ、Ⅱ型腹股沟疝患者,改良Kugel修补术与Lichtenstein修补术均可达到满意的疗效,而对于Ⅲ、Ⅳ型患者则更宜选择改良Kugel修补术。 Objective To study the selection of modified Kugel surgery and Lichtenstein surgery in the treatment of inguinal hernia.Methods The clinical data of 149 inguinal hernia cases performed modified Kugel repair （as modified Kugel group） from February 2014 to August 2015 were analyzed retrospectively,including 2 cases of type Ⅰ,12 cases of type Ⅱ,119 cases of type Ⅲ and 16 cases of type Ⅳ.There was 50 of direct hernia and 99 of indirect hernia in the group.During the same period,171 inguinal hernia patients received Lichtenstein repair （as Lichtenstein group） were as control group,including 4 of type Ⅰ,13 of type Ⅱ,141 of type Ⅲ and 13 of type Ⅳ.There was 60 of direct hernia and 111 of indirect hernia.Results All cases were complete the operation successfully.The operative time was shorter in modified Kugel group than that in Lichtenstein group,and the difference was statistically （P ＜ 0.05）.There was no statistical difference in patch infection rate and scrotal edema rate between two groups （P ＞0.05）.All cases were followed up for 6 to 24 months with an average of 13.5 months.The recurrence rate of hernia was 0.67％ and 4.68％ respectively in modified Kugel group and Lichtenstein group,and there was statistic difference between two groups （P ＜ 0.05）.Conclusions Both the modified Kugel repair and Lichtenstein repair can achieve satisfied effect for type Ⅰ and Ⅱ of inguinal hernia.But for type Ⅲ and type Ⅳ of inguinal hernia,the modified Kugel operation would be recommended preferentially.

关 键 词： 疝 腹股沟 疝修补术