经Bogros间隙无张力修补术治疗腹股沟嵌顿疝和普通疝的效果分析(1)
[摘要] 目的 评价经Bogros间隙无张力疝修补术治疗腹股沟嵌顿疝和普通疝的临床疗效。 方法 回顾性分析2010年1月～2016年4月在我院接受经Bogros间隙无张力疝修补术治疗的83例腹股沟嵌顿疝和957例普通疝患者的临床资料。 结果 嵌顿疝组患者在平均手术时间(45.62±8.73)min、住院天数(4.47±1.82)d和复工时间(9.14±4.35)d方面长于普通疝组的手术时间(38.58±5.15)min、住院天数(3.23±0.64)d和复工时间(8.12±3.67)d，各项差异均有统计学意义(P<0.05)；嵌顿疝组术中平均出血量(13.62±9.05)mL略高于普通组，差异无统计学意义(P>0.05)；嵌顿疝组和普通疝组术后感染分别为1例(1.2%)和6例(0.6%)，均在换药后痊愈。血(清)肿分别发生19例(22.89%)和168例(19.18%)，均自行吸收或穿刺抽液后痊愈。两组患者术后随访无复发。结论 与治疗普通腹股沟疝一样，经Bogros间隙无张力疝修补术是一种安全治疗嵌顿疝的手术方式。
[关键词] 疝；腹股沟；嵌顿性；疝修补术；Bogros间隙
[中图分类号] R656.21 [文献标识码] B [文章编号] 1673-9701(2017)03-0055-04
Analysis of the effect of Bogros gap tension-free repair in treatment of incarcerated hernia and ordinary hernia
HE Yanfei1 ZHANG Xiliang2 ZHANG Chaojun2
1.Medical Department， People's Liberation Army Navy General Hospital， Beijing 100048， China； 2.Department of General Surgery， People's Liberation Army Navy General Hospital， Beijing 100048， China
[Abstract] Objective To evaluate the clinical efficacy of Bogros gap tension-free hernia repair in treatment of incarcerated hernia and ordinary hernia. Methods The clinical data of 83 incarcerated hernia patients and 957 ordinary hernia patients undergoing Bogros gap tension-free hernia repair from January 2010 to April 2016 were retrospectively analyzed. Results The mean operative time(45.62±8.73) min， hospital stay(4.47±1.82) d and recovery time(9.14±4.35) d in incarcerated hernia patients were significantly longer than those in the normal hernia group with(38.58±5.15) min， (3.23±0.64) d and recovery time(8.12±3.67) d respectively， and the differences were all significant(P<0.05). The mean amount of bleeding in incarcerated hernia group was(13.62±9.05) mL， slightly higher than that in the normal hernia group， and there was no significant difference between the two groups(P>0.05). There was 1 case of postoperative infection in incarcerated hernia group(1.2%) and 6 cases in ordinary hernia group(0.6%). And the infections were all recovered after dressing. Blood (serum) swollen occurred in 19 cases(22.89%) and 168 cases(19.18%)， respectively， and were self-absorbed or recovered after puncture drainage. There was no recurrence in both groups during postoperative follow-up. Conclusion Similar to the treatment of common inguinal hernia， tension-free hernia repair via Bogros gap is a safe treatment of incarcerated hernia surgery.
[Key words] Hernia； Groin； Incarcerated；Hernia repair； Bogros gap
腹股溝嵌顿疝是指因疝内容物不能自行复位继而发生血运障碍的腹股沟疝，属普外科急症。一旦发生，无论其部位、大小均应行手术治疗，否则易形成疝内容物绞窄、坏死而导致严重后果[1]。但对于腹股沟嵌顿疝的手术方式选择在普外科还一直存在争议：传统手术方式存在复发风险[2]；腹腔镜下嵌顿松解、高位结扎术也已经有报道[3]；传统补片存在污染腹股沟的隐患[4]。近年随着解剖生理学发展和人工合成材料的广泛使用，已经有研究证实无张力疝修补嵌顿疝与传统修补手术相比是安全且更不易复发[5]。经Bogros间隙无张力疝修补术可通过对耻骨肌孔和腹横筋膜完全无张力修补而实现真正意义无张力修补，目前该手术方式对普通腹股沟疝的治疗已有报道[6]，但对经Bogros间隙无张力疝修补术治疗腹股沟嵌顿疝的效果分析较少，对其安全性也缺少循证医学证据。, 百拇医药(何雁飞 张夕凉 张朝军)
[关键词] 疝；腹股沟；嵌顿性；疝修补术；Bogros间隙
[中图分类号] R656.21 [文献标识码] B [文章编号] 1673-9701(2017)03-0055-04
Analysis of the effect of Bogros gap tension-free repair in treatment of incarcerated hernia and ordinary hernia
HE Yanfei1 ZHANG Xiliang2 ZHANG Chaojun2
1.Medical Department， People's Liberation Army Navy General Hospital， Beijing 100048， China； 2.Department of General Surgery， People's Liberation Army Navy General Hospital， Beijing 100048， China
[Abstract] Objective To evaluate the clinical efficacy of Bogros gap tension-free hernia repair in treatment of incarcerated hernia and ordinary hernia. Methods The clinical data of 83 incarcerated hernia patients and 957 ordinary hernia patients undergoing Bogros gap tension-free hernia repair from January 2010 to April 2016 were retrospectively analyzed. Results The mean operative time(45.62±8.73) min， hospital stay(4.47±1.82) d and recovery time(9.14±4.35) d in incarcerated hernia patients were significantly longer than those in the normal hernia group with(38.58±5.15) min， (3.23±0.64) d and recovery time(8.12±3.67) d respectively， and the differences were all significant(P<0.05). The mean amount of bleeding in incarcerated hernia group was(13.62±9.05) mL， slightly higher than that in the normal hernia group， and there was no significant difference between the two groups(P>0.05). There was 1 case of postoperative infection in incarcerated hernia group(1.2%) and 6 cases in ordinary hernia group(0.6%). And the infections were all recovered after dressing. Blood (serum) swollen occurred in 19 cases(22.89%) and 168 cases(19.18%)， respectively， and were self-absorbed or recovered after puncture drainage. There was no recurrence in both groups during postoperative follow-up. Conclusion Similar to the treatment of common inguinal hernia， tension-free hernia repair via Bogros gap is a safe treatment of incarcerated hernia surgery.
[Key words] Hernia； Groin； Incarcerated；Hernia repair； Bogros gap
腹股溝嵌顿疝是指因疝内容物不能自行复位继而发生血运障碍的腹股沟疝，属普外科急症。一旦发生，无论其部位、大小均应行手术治疗，否则易形成疝内容物绞窄、坏死而导致严重后果[1]。但对于腹股沟嵌顿疝的手术方式选择在普外科还一直存在争议：传统手术方式存在复发风险[2]；腹腔镜下嵌顿松解、高位结扎术也已经有报道[3]；传统补片存在污染腹股沟的隐患[4]。近年随着解剖生理学发展和人工合成材料的广泛使用，已经有研究证实无张力疝修补嵌顿疝与传统修补手术相比是安全且更不易复发[5]。经Bogros间隙无张力疝修补术可通过对耻骨肌孔和腹横筋膜完全无张力修补而实现真正意义无张力修补，目前该手术方式对普通腹股沟疝的治疗已有报道[6]，但对经Bogros间隙无张力疝修补术治疗腹股沟嵌顿疝的效果分析较少，对其安全性也缺少循证医学证据。, 百拇医药(何雁飞 张夕凉 张朝军)