Millikan手术治疗腹股沟疝的临床应用价值.pdf

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1、中国现代手术学杂志2012年6月第16卷第3期189[文章编号]1009—2188(2012)03—0189—03临床论著·Millikan手术治疗腹股沟疝的临床应用价值周晓武，王石林，张海宏，曹厚军(中国人民解放军空军总医院普通外科，北京100142)[摘要]目的评估Millikan手术治疗腹股沟疝的临床应用价值。方法用Millikan方法局麻下修补腹股沟疝52例，以同期行疝环充填式修补术的50例作为对照，观察两组手术效果、并发症、术后复发情况及生活质量等指标。结果Millikan方法同疝环充填式修补法在手术时间、麻醉药用量以及

2、围手术期并发症发生率方面比较无差异(P>0．05)。术后住院期间Millikan组镇痛药使用率明显低于对照组(38．5％VS．70．0％，P<0．01)。所有病例至少随访1年以上，两组均无复发。Millikan组慢性疼痛3月内仅1例，3月后消失；对照组术后3月慢性疼痛9例，超过1年5例。Millikan组1例有异物感，3月后消失；对照组3月时8例有明显异物感，其中5例时间超过了1年。两组术后慢性疼痛和异物感比较均有统计学差异(P<0．05)。结论Millikan术式安全可靠，疗效确切，术后慢性疼痛轻，异物感更少，生活质量更佳。[关

3、键词]疝，腹股沟；疝修补术，无张力；麻醉，局部[中图分类号]R656．21[文献标识码]BTheTherapeuticValueofMillikanProcedureintheTreatmentofInguinalHerniaZHOUXiao—WU，WANGShi·lin，ZHANGHai—hong，CAOHou4un(DepartmentofGeneralSurgery，AirForceGeneralHospitalD厂PL4，Beijing100142，China)Abstract：0bjectiveToevaluatethe

4、clinicalvalueofMillikanprocedureinthetreatmentofingui—Ha1hernia．MethodsMillikanprocedurewasperformedin52inguinalherniacasesunderlocalanes—thesia(asMillikangroup)．Mesh&andplugherniarepairwasmeanwhiledoneinthesimilar50cases(ascontrolgroup)．Theclinicaloutcomes，complicati

5、ons，herniarecurrenceandqualityoflivewereob·servedinthetwogroups．Resul~Therewasnosignificantdifferenceintheoperativetime，localanes—theticdosesandpostoperativecomplicationratebetweenthetwogroups(P>0．05)．TheapplicationrateofanalgesicsofMillikangroupwasobviouslessthanthat

6、ofcontrolgroup(38．5％VS70．0％，P<0．01)．Allcaseswerefollowedupmorethanoneyear，andnopostoperativerecurrencewasf_nundintwogroups．InMil—likangroup，onlyonepatientreportedchronicpainat3monthfollow—up，andhispaindisappearedafter3months．Incontrolgroup，9patientshadchronicpain，5pat

7、ientsofthemlastthepainoveroneyear．Simi—lady，foreignbodysensationwasfoundinonepatientafteroperationanddisappearedafter3monthsinMilli—kangroup，andwasin8patientsat3monthsafteroperation，fivepatientsofthemsufferedfromthebadfeel—ingoveroneyearincontrolgroup．Therewerestatist

8、icdifferenceinpostoperativechronicpainanddiscomfortsensationofforeignbodybetweentwogroups(P<0．05)．ConclusionMillikanprocedur