平片式修补与疝环充填式修补在腹股沟疝无张力疝修补术中的选择探讨

目的探讨平片式修补与疝环充填式修补两种术式在无张力疝修补术中的适用范围。方法493例次腹股沟疝患者依据不同的疝类型,分别选择疝环充填式修补术(巴德网塞补片)及平片修补术(戈尔软组织补片、贝朗平片及巴德平片)。对手术方法、手术指征、术后疼痛、并发症及复发率等进行观察。结果男性初发性腹股沟疝(疝环2.5 cm)、女性腹股沟疝、复发性疝、嵌顿性腹股沟疝选用平片修补术,仅1例术后6个月出现迟发性感染。男性初发性腹股沟疝(疝环2.5 cm)、尤其是直疝选用疝环充填式修补术,未见术后并发症及复发病例。结论采用疝环充填式修补与平片修补的无张力疝修补术具有安全、创伤小、恢复快的优点,但应依据疝的类型选择术式及补片材料。

The Clinical Selection and Application of Plug Mesh Operation and Lichtenstein Operation in Tension-free Hernia Repair

Objective To approach the applicable range of Plug Mesh operation（Bard PerFix Plug） and Lichtenstein operation（Gore-Tex Patch、Premilene Mesh、Bard Mesh） in tension-free hernia repair.Methods According to different hernia types,469 patients were treated by Plug Mesh operation or Lichtenstein operation of tension-free hernia repair.The operative method,surgical indications,postoperative pain,complications and recurrence rate were observed.Results Male primary groin hernia（hernia ring 2.5 cm）,female groin hernia,recurrent hernia,groin strangulated hernia were treated by Lichtenstein operation and only one case of delayed infection occurred after six months.Male primary groin hernia（hernia ring 2.5 cm）,specially direct hernia,were treated by Plug Mesh operation,and no postoperative complications and recurrence occurred.Conclusions The tension-free hernia repair involving Plug Mesh operation and Lichtenstein operation is safe,minimally invasive and rapid recovery,but the choice of technique and surgical patch material should be based on the type of hernia.