轻质量型网片在老年腹股沟疝无张力疝修补术中的应用

The clinical application of low-weight mesh for tension-free repair of inguinal hernia in the elders

目的总结轻质量型网片在老年腹股沟疝无张力疝修补术中的临床应用疗效。方法对120例（128侧）60岁以上老年腹股沟疝患者用轻质量型网片进行无张力疝修补术，观察术后早期并发症的情况、术后下床活动时间、住院天数、术后慢性疼痛、异物不适感的发生率和术后复发情况。结果全组均顺利实施手术，其中，实施薇普Ⅱ平片疝修补术72例（77侧），实施超普平片疝修补术10例（11侧），实施超普网塞平片疝修补术6例，实施超普疝修补装置疝修补术32例（34侧）。平均手术时间（43±12）min；术后早期发生阴囊浆液肿9例，尿潴留5例，切口血肿4例；平均术后下床活动时间（17．4±1．8）h，平均住院天数（7．4±1．9）d。术后6个月仅发生轻度慢性疼痛2例（VAS级评分〈2），发生率为1．7％（2／120）；异物不适感11例，发生率为9．1％（11／120）。随访6～48个月，平均随访（25．4-13）个月，无一例复发。结论用轻质量型网片进行老年腹股沟疝无张力疝修补术是安全、可靠的，术后慢性疼痛和异物不适感发生率较低。

Objective To evaluate low-weight mesh for tension-free repair of inguinal hernia in the elders. Methods 120 old patients （ age at 60 - 97 years） underwent tension-free repair of inguinal hernia by using low-weight mesh. The early complications, time of up and about, hospital stay, postoperative chronic pain, foreign body feelings and hernia recurrence were analyzed. Results The operations were successful in all cases and the average time of operation was （43 ± 12） min. 9 cases suffered from edema of the scrotum, 5 cases suffered urine retention, 4 cases suffered from incision hematoma. The average time of out- of-bed was （ 17.4 ± 1.8） h, the average hospital days was （7.4 ± 1.9） d. However, there were 1.7% （ 2/120 ） patients suffering from slight chronic pain and 9. 1% （ 11/120 ） patients complaining foreign body feelings. There was no recurrence after follow-up for 6 to 48 months. Conclusions The clinical application of low-weight mesh for tension-free repair of inguinal hernia in old age is safe and effective, with an additional advantage of low occurrence of chronic pain and foreign body feelings.