聚丙烯充填式网塞补片修补无张力腹股沟疝35例  

Tension-free inguinal hernia repair with polypropylene mesh plug in 35 cases

作　　者：曾祥勇[1] 潘辅全[1] 

机构地区：[1]海南医学院附属新华医院普外科,海南省海口市570311

出　　处：《中国组织工程研究与临床康复》2008年第32期6364-6366,共3页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:应用聚丙烯充填式网塞补片无张力修补腹股沟疝,已逐渐被广大外科医生所接受,但目前临床经验尚少。目的:回顾性分析传统疝修补术、聚丙烯充填式网塞补片无张力腹股沟疝修补术患者的疗效及术后情况。设计、时间及地点:病例分析,2003-03/2007-10海南医学院附属新华医院普外科收治腹股沟疝修补术患者115例。对象:115例中,男76例,女39例;年龄26～81岁,平均61.3岁。单侧斜疝78例,直疝11例,股疝2例,复发性疝12例,双侧斜疝12例。传统疝修补术80例,聚丙烯充填式网塞补片无张力腹股沟疝修补术35例。采用材料为美国Bard公司的定型产品,包括网状锥形疝环充填物和成型补片。方法:网塞补片无张力腹股沟疝修补术中根据疝环的大小选择网塞的型号和数量,将疝囊的中心点与疝塞的顶端贯穿缝合,网塞置入后外瓣与疝环边缘做间距0.5～0.8cm的间断缝合固定。传统疝修补术主要采用Bassini术式、McWay术式、Shouldice术式。主要观察指标:①手术时间、下床活动时间、平均住院时间。②术后应用止痛剂,尿潴留、阴囊肿胀、术后复发情况。结果:115例全部治愈。充填式网塞补片无张力腹股沟疝修补术35例,手术时间平均40min;术后平均8h开始下床活动,平均住院6.2d;术后发生尿潴留2例,术后应用止痛剂3例,术后阴囊肿胀1例,无伤口感染、阴囊积液等并发症;术后随访6～36个月无复发。传统疝修补术80例,手术时间平均56min;术后平均68h开始下床活动,平均住院11.6d;术后发生尿潴留9例,术后应用止痛剂37例,术后阴囊肿胀1例,无伤口感染、阴囊积液等并发症;术后随访6～36个月复发9例。结论:聚丙烯充填式网塞补片无张力腹股沟疝修补术能满足修补和加强耻骨肌孔区域的要求,与传统疝修补术相比具有明显优势,组织相容性好。BACKGROUND： It has been generally accepted that polypropylene mesh tension-free hernia repair may repair the inguinal hernia, but the clinical application is not wide. OBJECTIVE： To analyze retrospectively the effect of polypropylene mesh plug tension-free hernia repair versus the traditional herniorrhaphy for inguinal hernia. DESIGN, TIME AND SETTING： Case analysis was performed among 115 cases who underwent inguinal hernia in Department of General Surgery, Affiliated Xinhua Hospital of Hainan Medical College from March 2003 to October 2007. PARTICIPANTS： The involved patients were 76 males and 39 females, aged 26-81 years with a mean of 61.3. There were 78 cases with lateral indirect hernia, 11 direct hernia, 2 femoral hernia, and 12 bilateral indirect hernia. 35 of 115 patients were operated with polypropylene mesh tension-free hernia repair and 80 patients were provided at traditional repair method. Mesh cone hernia ring and patches were offered from Bard Company （USA）. RESULTS： The size of hernia ring was selected based on the pattern number and amount of mesh plug. Transfixing suture was performed along the center and tip of hernial sac. Subsequent to the mesh plug implantation, the flap was processed into interrupted suture with hernia ring at a interval of 0.5-0.8 cm. Traditional herniorrhaphy was chiefly consisted of Bassini, McWay and Shouldice operative types. MAIN OUTCOME MEASURES： Operative duration, out of bed activity time and average hospitalization time were observed Utility of anodyne, uroschesis and scrotal swelling were detected after operation. RESULTS： All patients were cured. There were 35 patients operated with mesh tension-free repair of inguinal hernia. The operation mean time was 42 minutes. The mean time of getting out of bed was 8 hours after operation. The mean hospitalization time was 6.2 days. There were 2 patients with uroschesis, 3 patients utilizing the anodyne, and 1 patient with scrotal swelling after operation, without complications about wound i

关 键 词：腹股沟疝 外科手术 无张力修补术 生物材料 

分 类 号：R318[医药卫生—生物医学工程]