疝环充填式与普理灵疝装置疝修补术治疗老年腹股沟疝的临床疗效比较

Comparison Between Mesh Plug Tension-free Herniorrhaphy and Polypropylene-prolene Hernia System for the Treatment of Elderly Patients of Inguinal Hernia

【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老年腹股沟疝的手术效果。【方法】80例老年腹股沟疝患者随机分为A组和B组，每组40例。A组采用疝环充填术式，B组采用普理灵疝装置术式行无张力疝修补术，术后随访6～10个月，比较两组手术时间、术后疼痛评分、术后下床时间、术后并发症。【结果】B组术后8hVAS评分显著高于A组（P〈0．05）；B组术后局部异物感发生率显著低于A组（P〈0．05）；两组手术时间、术后下床时间、术后24h疼痛程度及术后其他并发症比较无显著差异（P〉0．05）。【结论】疝环充填式及普理灵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。但普理灵疝装置在术后局部并物感方面优于疝环充填式，更适合老年患者。

[Objective] To compare the therapeutic effects of mesh plug tension-free herniorrhaphy and polypropylene-prolene hernia system（PHS）for the treatment of elderly patients of inguinal hernia. [Methods] Eighty elderly patients suffered inguinal hernia were randomized into two groups： Group PLUG （ n = 40） was treated with mesh plug＆ patch, and Group PHS （ n =40）was treated with polypropylene-prolene hernia system. All patients were followed up for 6-10 months. The operation time, VAS of pain, time Of getting out of bed and postoperative complications（such as infection, seromas, abdominal discomfort due to stiffness, uroschesis and the rate of re-herniation） were compared between two groups . [ResultslThe painful degree at 8 hours after operation and foreign body sensation had significant difference between two groups（ P d0.05）. The time of getting out of bed, painful degree at 24 hours after operation, the incidence of infection, seromas and uroschesis and recurrence rate had no obvious difference between two groups（ P 〉0.05）. [Conclusion] PHS and Mesh plug＆ patch tension-free herniorrhaphy has advantages such as fast recovery and low recurrence rate. Because the foreign body sensation of PHS is less than that of mesh plug＆ patch tension-free herniorrhaphy, PHS is more suitable for elderly patients.