无张力疝修补术在中老年腹股沟疝的临床应用

Clinical application of mesh plug tension-free herniorrhaphy for inguinal hernia in middle-senile patient

目的研究疝环充填式（Mesh Plug）无张力疝修补术在中老年男性腹股沟疝的临床应用价值。方法将252例中老年男性腹股沟疝病人,随机分为A、B两组。A组128例为实验组,采用Mesh Plug无张力疝修补术术式;B组124例为对照组,采用传统疝修补术术式。随访5-7年。结果 A、B两组的手术时间没有统计学意义（P〉0.05）;A组术后疼痛程度轻于B组（P〈0.01）;下床活动时间、生活自理时间、住院时间优于B组（P〈0.01）;A组的手术直接和间接并发症发生率均低于B组（P〈0.01）;A组术后复发率明显低于B组（P〈0.01）;但A组的住院费用明显高于B组（P〈0.01）。结论疝环充填式无张力疝修补术治疗中老年腹股沟疝,在减轻病人术后疼痛、缩短术后康复时间、减少术后并发症、降低手术复发率方面优于传统疝修补术式。

Objective The aim of the study was to evaluate the value of the mesh plug tension-free herniorrhaphy for inguinal hernia in middle-senile patient.Methods 252 middle-senile male patients with hernia received operation.We randomly divided them into Group A and Group B.Group A included 128 cases was repaired with the mesh plug tension-free herniorrhaphy.Group B included 150 cases was repaired with conventional herniorrhaphy.The Follow-up period was 5 to 7 years.Results The duration of surgery in the different groups had no significant difference（P〉0.05）.Patients in Group A had suffered less pain after operation than those in Group B（P〈0.01）.Time of back to normal physical activities,back to normal life and hospitalization in Group A were shorter than those in Group B（P〈0.01）.The direct operation complication rate and the indirect operation complication rate in Group A were less than that in group B（P〈0.01）.The recurrence rate in Group A was rarer than that in Group B（P〈0.01）.The total cost of hospitalization in Group A was higher than that of Group B（P〈0.01）.Conclusion Comparing with conventional herniorrhaphy for inguinal hernia in middle-senile patients,t he mesh plug tension-free herniorrhaphy required less pain,shorter time in back to normal activities,less operation complication and rarer recurrence rate.