疝环充填式与PHS两种疝修补术的疗效对比分析

The therapeutic comparison between and in bilayer patch device tension-free hernia repair

目的探讨两种无张力疝修补术的优缺点。方法采用美国Bard公司的疝环充填物及网状补片和强生公司的PHS，对各类型腹股沟疝行无张力修补174例，其中疝环充填式（Rutkow手术）103例（A组），强生公司PHS修补术71例（B组）。结果A组手术时间、尿潴留和阴囊水肿发生率均显著少于B组（P〈0．01）；A、B两组术后自主能力恢复时间、术后24h疼痛程度比较差异无统计学意义（P〉0．05）。结论腹股沟直疝及疝环较大的斜疝，尤其是复发疝者，应尽量选用PHS修补术手术，疝环较小的斜疝可选用Rutkow手术。

Objective To evaluate those two kinds of tension-free hernioplasty. Methods All cases were adopted by the tension-free hernioplasty which was used the mesh＆plug offered by Bard Company and Johnsonil Companyb patch device in the USA. Among the 174 cases, 103 cases were treated by Rutkow repair（ A group） and the other 71 cases were treated by bilayer patch device （ B group）. Results The operation time for A group was less than B group. The people got urinary retention and hydrocele in A group were less than in B group （P 〈 0. 01 ）. A group and B group had the same cure time and the same postoperative pain in 24 hours （P 〉 0. 05 ）. Conclusion It is suggested that patients who get the direct hernia or indirect with big hernia, especially recurrent hernia should be operated by the Rutkow method. On the other hand, using bilayer patch device for indirect hernia with small hernia ring is preferred.