| Background:The inguinal hernia is a kind of abdominal external hernia that occurs in the region of groin,and includes inguinal hernia,direct hernia and femoral hernia.The main symptoms of patients with inguinal region can be reversible or irreversible tumor,leads to local pain and discomfort,affect the normal activities and the quality of life of patients.Inguinal hernia is a common surgical disease.When adult got inguinal hernia,surgery is the only method to cure.With the continuous improvement of the concept of sugery repair and medical materials,the main development stages of hernia surgery included:the open tension hernia repair,open tension-free hernia repair and laparoscopic tension-free herniorrhaphy.At present,there are many kinds of hernia surgery,and they are widely used in clinic and hold important postion respectively.The different choices of the operation will lead to different results,so how to make a better treatment of inguinal heinia?Currently,there are many studies on the advantages and disadvantages of different methods.However,for different types of hernia or different patient groups,the clinical analysis and research of how to choose the specific operation method is rare.The purpose of this paper is to summarize the effect and experience of the application of Lichtenstein in type I and type-II inguinal hernia(Chinese Medical Association Classifcation Standard in 2004)in our hospital.Purpose:1.To observe the clinical effect of Lichtenstein tension-free hernia repair in treatment of type-Ⅰ and type-Ⅱ inguinal hernia(CMA Classifcation Standard in 2004).2.To discuss the clinical value of Lichtenstein tension-free hernia repair,to provide a theory evidence for the clinical application and individualized treatment of this herniorrhaphy.Methods:Between January 2014 and July 2016,69 cases of type-Ⅰ and type-Ⅱ inguinal hernia patients who underwent Lichtenstein tension-free hernia repair were collected in the first affiliated hospital of Dalian medical University.Among them,type-Ⅰ hernia in 27cases,type-Ⅱ hernia in 42 cases;indirect hernia in 30 cases,direct hernia in 39 cases;male in 61 cases,female in 8 cases;age range from 37 to 75,average 45.8± 14.3.Exclusion criteria:innutrion,cachexia,Severe coagulation disorders,serious heart,brain,kidney diseases and immune disorders,type-Ⅲ and type-Ⅳ inguinal hernia,femoral hernia,bilateral hernia and incarcerated hernia.The postoperative recurrence rate,postoperative comlications,operative time,blood loss,length stay after operation,postoperative pain,postoperative discomfort and other clinical indices were analyzed and studied.Then accoding to type-I and type-Ⅱ,indirect hernia and direct henia,this group of cases divided into two subgroups,and the indexes were analyzed and compared.Access to relevant information by telephone follow-up.Results:All 69 patients were healed by Lichtenstein tension-free hernia repair.Average operative time were 42.1 ±8.6 min,average length stay after operation were 4.1±1.2d,average blood loss were 5.83± 1.83ml,no recurrence by follow up,postoperative comlications:2 cases with incisional infection,lcase with urinary retention.The V.A.S in 24 hours,3 months and 6 months were 2.00±1.2,0.4±0.2,0.1 ±0.4.postoperative discomfort rate:no discomfort were 92.0%,mild level were 6.4%,moderate level were 1.6%.Type-Ⅰ group and type-Ⅱ group,indirect hernia group and direct hernia group have no significant difference in the clinical indicators,and no statistical significance(P>0.05)Conclusion:(1)The clinical effect of Lichtenstein operation in the treatment of type-Ⅰ and type-Ⅱ inguinal hernia is fine.It has the advantages of simple operation,safety and efficacy,quick recovery and low complication rate,and agrees with the individualized treatment principle.(2)The application of self-fixating mesh in Lichtenstein can simplify the operation procedure and save the operation time,and in theory,avoide the possible causes of chronic pain.But there is no concrete evidence to support and the need for further research. |
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