疝环充填式网塞与普理灵疝装置修补腹股沟疝的对比研究

The comparative study of mesh-plug and PHS tension-free hernioplasty for inguinal hernia

目的通过对疝环充填式(mesh-plug)和普理灵疝装置(PHS)两种疝修补方式、术后效果进行对比研究,以求对不同患者选择更合理的腹股沟疝修补方法。方法采用前瞻性随机分组,将符合条件的患者分为两组,每组20例,分别实施PHS和mesh-plug疝修补。记录术后恢复的多项指标,并通过随访记录发生一般并发症和术后伤口疼痛、异物感等不适感的情况,对统计资料进行相应的检验。结果mesh-plug组手术时间平均无差显著性异。mesh-plug组出现伤口异物感和麻木感高于PHS组(P<0.05)。结论mesh-plug和PHS无张力疝修补术均具有术后复发率低、并发症少等优点。PHS能够减少手术后不适感、降低治疗费用。

Objective We compared the mesh-plug＆ patch operation tension-free hernioplasty and polypropylene hernia system（PHS） hoped to seek the more rational individualized inguinal operation for different patients. Methods It is a randomized, parallel controlled prospective study. All the patients met inclu- sion criteria patients were randomized to two groups according to the randomization schedule, with each group of 20 patients. The patients were undergone PHS and mesh-plug tension-free hernioplasty respectively. The following indicator were recorded, operating times, the postoperative time of movement from the bed and urinating, the highest temperature postoperative, the time in hospital postoperative, the duration time of pain, the recover time. The cases of complication that included wound infection, retention of urine and recurrence and the discomfort cases that included the wound pain, the sense of local foreign body and numbness of wound were recorded by follow-up. x^2 test was used to analyze the quantity data and t test was used to analyze the quality data by the SPSS 10.0 statistic software pack. Result The operating times of mesh-plug group and PHS group were 73.8 minutes and 56.5 minutes respectively, there are significant difference between them （P 〈 0.05）. The recovery progress has no difference. There is one retention of urine in each group with no incision infection and recurrence happened. There is no difference in wound pain between two groups. The frequency of sense of foreign body and numbness in wound in mesh-plug group is more than PHS group with significant difference （P 〈0.05）. Conclusion Mesh-plug and PHS tension-free hemioplasty all have advantage of low recurrence rate, few complication and quick recovery and are popularized in clinic. Mesh-plug tension-free hernioplasty is indicated for most inguinal hernia patients owing to the simple operation, while PHS is more rational in design and more effective in preventing recurrence. It is suitable for thin patient or patient who has week or large defect transversalis fascia and can reduce the discomfort postoperative and the treat expense.