两种无张力疝修补术的疗效对比分析

目的:比较两种无张力疝修补术的临床特点和适应症。方法:采用美国Bard公司的疝环充填物和网状补片及强生公司的双层补片(bilayer patch device),对152例多种类型的腹股沟疝行无张力修补,其中疝环充填式(Rutkow手术)103例(A组),双层补片术49例(B组)。结果A组手术时间、尿潴留和阴囊水肿发生率均显著少于B组(P<0.01);而两组术后自主能力恢复时间和术后24 h疼痛程度比较,无显著差异(P>0.05)。结论:无张力疝修补术比传统的手术方式具有很大的优势;直疝及疝环较大的斜疝,尤其是复发疝者,应尽量选用双层补片术,疝环较小的斜疝可选用Rutkow手术。

Comparison of curative effects of free-tension hernia repair between with mesh prefix plug and bilayer patch device

Objective: To compare the curative effects of free tension hernia repair between with mesh prefix plug and bilayer patch device. Methods: 152 cases with hernia were performed by free-tension hernioplasty.Among them,103 ones(A group) were repaired with mesh prefix plug and 49 ones(B group) with bilayer patch device.Their complications and prognosis were followed-up for 2 to 4 years.Results: The operative time in group A was less than in group B and the incidences of urinary retention and hydrocele in group A were lower than those in group B(P<0.05).The cure time and postoperative pain in 24 h of both groups were similar. Conclusion: It is suggested that the patients with direct hernia or indirect big hernia,especially recurrent hernia should be operated by Rutkow method,and the bilayer patch device is preferred for indirect hernia with small hernia ring.