巴德疝塞与普理灵疝装置在腹股沟疝中的应用体会  

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

作　　者：钟鸣[1] 王昆华[1] 罗华友[2] 欧阳一鸣[1] 张勇学[1] 龚昆梅[1] 

机构地区：[1]云南省第一人民医院普外科,昆明650032 [2]昆明医学院第一附属医院普外科,昆明650031

出　　处：《中国临床医学》2005年第2期233-234,共2页Chinese Journal of Clinical Medicine

摘　　要：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7～18 h进食,术后32～48 h下床活动.Plug组和PHS组平均手术时间分别为42 min和53 min;平均住院日期分别为3.2d和3.4 d.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.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.

关 键 词：普理灵疝装置 腹股沟疝 疝塞 应用体会 PROLENE 2002年12月 无张力疝修补术 2004年6月 2003年1月 system 平均手术时间 并发症发生率 PLUG 腹横筋膜 聚丙烯丝网 1999年 无张力修补 修补方法 mesh PLUG 修补材料 临床资料 

分 类 号：R656.21[医药卫生—外科学] R969.4[医药卫生—临床医学]