自制锥型花瓣充填物疝环充填式无张力疝修补术的应用体会及其力学原理分析

Clinical Application of the Modified Plug Mesh Tension-free Hernioplasty by Self-made Cone-type Petal-like Obturators

目的探讨应用自制锥型花瓣充填物行疝环充填式无张力疝修补术的临床价值,并分析其力学原理。方法回顾性分析145例病人（156例次）行改良疝环充填式无张力疝修补术治疗的临床资料。术中将一张4 cm×4 cm的正方形网片各边的中间缝合,自制成圆锥状花瓣式小型充填物,另用一5 cm×7 cm网片作为垫片,行改良疝环充填式无张力疝修补术。结果本组手术过程顺利,平均手术时间42（30-80）min,平均出血5（2-10）ml,术后4-24 h下地活动,2-5 d出院。无明显术后并发症。随访3-6月无复发。结论改良疝环充填式无张力疝修补术具有手术创伤小,更符合力学原理,术后病人痛苦少,恢复快,复发率更低等优点。

Objective To investigate the mechanical principle and the value of the modified plug mesh tension-free hernioplasty by self-made cone-type petal-like obturators.Methods The clinical data of 145 cases（156 times） of modified plug mesh tension-free hernioplasty were retrospectively reviewed.The cone-type petal-like obturators were made by suturing the middle points of the sides of the 4 cm×4 cm square mesh.Then the obturator was used as the plug and another 5 cm×7 cm mesh was used as the packing piece.Results The average time of operation was 42 minutes.The average amount of bleeding was 5 ml.No complication was found after operation.Patients could moved around out of the bed in the 4～24 hours after operation.All of the patients were followed up for 3～6 months.No recurrence during the follow-up.Conclusion It shows the advantages of easier handling,less pain,quicker recovery and lower recurrence rate of the modified plug mesh tension-free repair.