巴德疝塞与普理灵疝装置在腹股沟疝中的应用体会

目的:探讨更有效的疝修补方法。方法:分别采用由聚丙烯丝网制成的巴德疝塞(Bard mesh plug & patch)和普理灵疝装置(poly propylene prolene hernia system, PHS)为修补材料行无张力疝修补术。1999年8月~2002年12月行巴德疝塞修补术60例(Plug组), 2003年1月~2004年6月行普理灵疝装置修补术60例(PHS组),比较两组临床资料。结果:各例于术后7~18h进食,术后32~48h下床活动。Plug组和PHS组平均手术时间分别为42min和53min;平均住院日期分别为3.2d和3.4d。术后并发症发生率分别为11.67%(7/60)和6.67%(4/60),两组有显著差异(P<0.05)。随访2~43 d均无复发。Plug组随访率90%(54/60),PHS组随访率95%(57/60)。结论:Bard疝塞及prolene疝装置都能很好地对腹股沟疝行无张力修补,但因修补的原理不同而各具特点。Bard疝塞对于腹膜较薄或腹膜与腹横筋膜粘连严重但腹横筋膜缺损不太大的较为适用;prolene疝装置则对腹横筋膜或疝环缺损大和较瘦病人更为适宜,而且对耻骨肌孔进行完整修补,更为可靠。

The Application of Bard Mesh Plug and Poly Propylene -Prolene Hernia System in Inguinal Hernia Patients

Objective: To investigate more effective procedures of herniorhaphy. Methods: Hernia repair were performed using Bard Mesh plug & patch and poly propylene - prolene hernia system as repair material. 60 cases (1999,8~2002,12) were received hernia repair using Bard Mesh plug & patch (Plug group),and 60 cases (2003,1~2004,6) received poly propylene-prolene hernia system(PHS group).Clinical data of both groups were analyzed. Results: The average operating time of Plug group was 42 minutes,while PHS group was 53 minutes.All patients took food 6~18 hours post operation and took activity away from bed 32~48 hours post operation. Hospital stay time was 3.2 days and 3.4 days,respectively,and complication rate was 11.67%(7/60) and 6.67%(4/60) respectively in two groups. The difference was significant in two groups.During the follow-up time of 2~43 days, no recurrence occurred. Conclusion:Both Bard Mesh plug and PHS can be used effectively in tension-free herniorrhaphy.They have their own characteristic due to different repair mechanism. Bard Mesh plug adapt especially to those whose peritoneum is weak or peritoneum conglutinate with transversails fascia severely but transversails fascia defect is not much big. PHS adapt especially to those whose transversails fascia or hernia ring defect is big and thin patients,and it can repair myopectineal orifice fully to achive better curative effect.