疝环充填式与普理灵疝装置两种疝修补术的疗效对比分析

The therapeutic comparison between plug & mesh and polypropylene prolene hernia system in tension-free hernia repair

目的对比分析疝环充填式与普理灵疝装置两种无张力疝修补术治疗腹股沟疝的手术效果。方法1999年8月到2003年6月行无张力修补术治疗521例腹股沟疝,其中应用疝环充填术式378例(A组),普理灵疝装置术式143例(B组),观察两者的手术时间、术后疼痛程度、术后自主能力恢复时间、并发症和复发率。结果A组手术时间、术后8小时疼痛程度、尿潴留和阴囊水肿发生率均显著少于B组(P<0.01);A组术后局部异物感发生率显著高于B组(P<0.01);A、B两组术后自主能力恢复时间、术后24小时疼痛程度及复发率比较无显著差异(P>0.05)。结论疝环充填式及普理灵疝疝装置无张力疝修补术治疗腹股沟疝,均有术后恢复快、复发率低的优点,但在手术时间、术后8小时疼痛程度及并发症发生率方面各有优缺点,根据患者的具体情况选择个体化的修补方案可提高手术效果。

Objective To compare the results of polypropylene prolene hernia system(PPHS) and Mesh Pluy & patch in tension-free inguinal hernia repair.Methods From August 1999 to June 2003,521 patients with inguinal hernia underwent tension-free hernia repair.Among them,378 patients were treated with Mesh plug & patch(group A)and 143 patients with polypropylene prolene hernia system(PPHS-group B).The operative time,postoperative painful degree,independent walking time,complications and recurrence rate were observed in the both groups.Results The operation time, painful degree of 8 hours after operation,retension of urine,scrotal edema rate and foreign body sensation had significant difference between two groups.And independent walking time,painful degree of 24 hours after operation and recurrence rate were no obvious difference between two groups.Conclusion PPHS and Mesh plug & patch in tension-free inguinal hernia repair have an advantages of fast recovery,and low recurrence rate.But about operative time,painful degree of 8 hours postoperation and complications rate,they have advantages and disadvantage of themselves.According to the patients concrete condition to select individulized operative project,it can imporove the surgical therapeutic effects.