不同疝修补装置治疗腹股沟疝患者的对比研究

目的 对比研究疝环充填式无张力疝修补术和普理灵疝装置无张力疝修补术手术方式及术后效果,以探求对不同患者选择更合理的个体化腹股沟疝手术治疗方法.方法 采用前瞻性随机化分组对照研究,用随机数字表法将符合纳入条件的患者分为两组,每组40例,分别进行双层平片疝装置(普理灵polypropylene-prolene hernia system,PHS)无张力疝修补术和疝环网塞补片式(mesh-plug)无张力疝修补术.记录手术及术后并发症相关指标.采用SPSS 10.0统计软件包,对计量资料进行两组t检验或秩和检验,对计数资料进行X2检验.结果 mesh-plug组的手术时间平均为73.8 min,PHS组手术时间平均为56.5 min,P＜0.05,差异有统计学意义.术后恢复过程差异无统计学意义.mesh-plug组出现伤口异物感和麻木感的病例较PHS组多,P＜0.05,差异有统计学意义.结论 疝环充填式无张力疝修补术因其操作简单,适合于大多数腹股沟疝患者.但普理灵疝修补装置设计更合理,能够更有效地预防复发,对于较瘦的患者、腹横筋膜薄弱、缺损较大或骑跨疝的患者更为适合,能够减少手术后不适感.

Comparative study of mesh-plug and polypropylene hernia system tension-free hernioplasty for inguinal hernia

Objective To compare the effects of mesh-plug and polypropylene hernia system(PHS) tension-free hernioplasty so as to explore the strategy of treatment for different patients. Methods Eighty patients with inguinal hernia were assigned into 3 equal groups according to the randomization schedule: PHS group and mesh-plug group. The operating time and the outcomes were recorded. Results The operating times of the mesh-plug group was 73.8 minutes significantly longer than that of the PHS group (56.5 minutes, P＜0.05). There was no significant difference in the recovery progress between these 2 groups. The numbers of patients who had sense of foreign body and numbness in the mesh-plug group were significantly greater than those in the PHS group ( both P＜0.05). Conclusions Mesh-plug tension-free hernioplasty is indicated for most inguinal hernia patients owing to the simple operation. More rational in design and more effective in reduction of recurrence, PHS is suitable for thin patients or patients with week or large transversalis fascia defection. And PHS is able to reduce the postoperative discomfort.