无张力疝修补术疗效分析

目的通过对Lichtenstein、疝环充填式、PHS三种无张力疝修补手术方式、术后复发率以及并发症发生率等方面进行比较,寻找一种易于掌握,疗效确切的术式。方法对我院自2002年2月至2007年12月463例实施无张力疝修补术患者的临床资料进行回顾性地分析。结果所有患者均行无张力疝修补术,根据手术方式分为叁组：聚丙烯材质充填式组（218例）,膨体聚四氟乙烯平片组（221例）,普理灵疝补片（PHS）组（24例）。术后复发率：聚丙烯材质充填式组为0．5％（1／218）,膨体聚四氟乙烯平片组为0．5％（1／221）,PHS组为0（0／24）,三组差异无显著性。术后疼痛发生率：聚丙烯材质充填式组为9．0％（19／218）,膨体聚四氟乙烯平片组为4．0％（9／221）,PHS组为4．0％（1／24）,聚丙烯材质充填式组与膨体聚四氟乙烯平片组和PHS组差异显著,有统计学意义（P〈0．05）。术后阴囊血肿发生率：聚丙烯材质充填式组为1．8％（4／218）,膨体聚四氟乙烯平片组为2．0％（5／221）,PHS组为4．0％（2／24）,PHS组与聚丙烯材质充填式组和膨体聚四氟乙烯平片组差异,有统计学意义（P〈0．05）。结论膨体聚四氟乙烯平片无张力疝修补术是一种疗效确切,术后并发较少,适宜广泛推广的一种术式。

Clinical study of different henri oplasties in inguinal hernia

Objective To evaluate the therapeutic benefits, the postoperative complications and the recurrent rate of three styles of hernioplasties such as Lichtenstein tension-free hernioplasty, the plug ＆ mesh hernioplasty and Prolene Hernia System hernioplasty （PHS）. Methods From February 2002 to December 2007, 463 patients offered tension - free bernioplasty were analyzed retrospectively. Results All 463 patients were offered tension - free hernioplasty. Accorrding to operative methods, they were divided into three groups： Liehtenstein tension-free group（n =221 ） ,the plug ＆ mesh group（n =218） and PHS group （n =24）. The recurrent rate of Lichtenstein tension-free group was 0.5% （ 1/221 ）, The recurrent rate of the plug ＆ mesh group was O. 5% （1/218） and the rate of the PHS group was 0（0/24）. The difference among the three group was no significance. The pain rate after operation of Liehtenstein tension-free group was 4.0% （9/221） , The rate of the plug ＆ mesh group was 9.0% （19/218） and the rate of the PHS group was 4.0% （1/24）. The significant difference between the mesh only group , Licbtenstein tension-free group and PHS group was identified （ P 〈 0.05 ）. The hematoma of scrotum of the Lichtenstein tension-free group was 5.0% （5/221）, The rate of the plug ＆ mesh group was 1.8% （4/218） and the rate of the PHS group was 8.0% （4/24）. The significant difference among the mesh only group, Lichtenstein tension-free group and PHS group was also identified （ P 〈 0.05 ） . Conclusions The tension-free hernioplasty by e-PTFE mycromesh was demonstrated the advantages of less postoperative pain, less complications, less reeurrence, which is the better way to treat ingninal hernia at the present time.