无张力疝修补术在老年腹股沟嵌顿疝中的应用

目的 探讨嵌顿性腹股沟疝的合理术式。方法回顾性分析1999年1月-2003年10月间32例嵌顿性腹股沟疝的临床资料，总结其临床特点和疝修补手术的方式。结果32例病人中1例因肺炎、呼吸衰竭死亡，其余均康复出院；术前16例病人有合并症，术后6例病人出现并发症。21例行无张力疝修补术，无1例复发，7例行Bassini术后有3例复发。经统计学检验，无张力性疝修补组与张力性疝修补组在嵌顿时间、手术时间无明显差异，而复发率接近于有统计学差异。4例病人在切除坏死小肠后行单纯内环修补术。结论无张力疝修补术治疗腹股沟嵌顿疝是安全可行的，疝环充填式无张力疝修补术及普理灵疝装置无张力疝修补术可以根据疝的不同分型而选择使用。

Use of tension-free herniorrhaphy for incarcerated inguinal hernia in elderly patients

To find rational method to repair incarcerated inguinal hernia. 32 patients with incarcerated inguinal hernia were analyzed retrospectively from January 1999 to October 2003. Clinical feature of the disease and various types of herniorrhaphy were summarized. All patients except one death caused pneumonia and respiratory failure recovered. 16 cases had preoperational concomitant diseases and 6 cases had postoperational complications. 21cases who underwent tension-free herniorrhaphy had no recurrence, while 3 of 7 cases who underwent Bassini operation recurred .According to statistic test, there were no difference in incarceration time and operation time between tension-free group and tension group, while there was nearly difference in recurrence rate between two groups. 4 cases were performed a simple internal ring repair after the necrotic intestine were dissected. Conclusion] Tension-free herniorrhaphy are feasible and safe to treat incarcerated inguinal hernia. Plug & patch and prolene hernia system(PHS) tension-free herniorrhaphy can be alternatively used according to the different type of classification .