322例Bard补片无张力疝修补术的临床治疗体会

目的总结Bard补片疝环充填式无张力疝修补治疗腹股沟疝的临床经验。方法回顾性分析江阴市人民医院近3年322例无张力疝修补术的临床资料。结果322例患者均痊愈出院，平均手术时间68．4min，平均术后恢复时间6．6d，平均总住院时间9．9d。大于60岁、合并内科疾病、复发疝、嵌顿疝、双侧疝及单侧复合疝的患者较年青患者及无并发症、初发疝、易复性疝、单侧单发疝患者手术时间长、术后恢复慢以及总住院时间延长。术后早期切口轻度疼痛，腹股沟区异物感2例（0．6％），切口感染1例（0．3％），尿潴留13例（4．0％），阴囊积液18例（5．4％）。299例获随访时间1-36个月，1例有腹股沟区异物感，无一例复发。结论老年腹股沟疝具有其独特性和复杂性，施行Bard补片疝环充填式无张力疝修补术需正确认识腹股沟区解剖结构，严格遵循手术原则，熟练掌握手术技巧，合理治疗合并症及处理术后并发症。

Clinical Experience of Bard Mesh-plug Tension-free Hernia Repair: A Report of 32 Cases

[ Objective ] To summarize the clinical experience of Bard mesh-plug tension-free hernia repair in inguinal hernias. [ Methods] Clinical data of 322 patients with inguinal hernia treated by tension-free hernia repair were analyzed statistically in Jiangyin People g Hospital in recent 3 years. [ Results] All cases were cured, with average operation time of 68.4 min, postoperative recovery time of 6.6 days and hospital staying time of 9.9 days in average. The patients over 60 years, with internal diseases, recurrent hernias, incarcerated hernias, bilateral hernias and unilateral complex hernias had longer operation time, postoperative recovery time and total staying time, than those young patients, or patients without internal diseases, or with primary hernias, reducible hernias, and unilateral single hernias. There was early slight wound pain in most cases, foreign body sensation in the groin region in 2 cases（0.6% ）, wound infection in 1 case（0.3% ）, urinary retention in 13 cases{4.0% ）, serotal hydrocele in 18 cases{ 5.4% }. 1 case presented foreign body sensation and no case recurred in 299 patients＇following up of 1 ~ 36 months. [ Conclusion] The elderly hernias had individuality and complexity. Bard mesh-plug tension-free hernia repair should be performed with correct recognition of anatomic structure in groin region, a standard operation technique and rational postoperative therapy of complications.