目的 探讨带记忆弹簧圈（MK）补片在无张力修补中、小切口疝中的应用。方法 回顾性分析2005年1月至2007年1月期间我院实施MK补片下置术修补腹壁中、小切口疝25例患者的临床资料，其中初发21例，复发4例。结果 22例一期愈合，3例发生切口皮下积液，经穿刺抽吸处理后治愈。住院7～15 d，均痊愈出院。随访10个月至2年，无复发病例。结论 用MK补片下置术修补腹壁中、小切口疝经济、安全、有效、感染风险降低。
Objective To investigate the indication, approaches andpreventionof complications in treatment of female stress urinary incontinence(SUI) with tension-free vaginal tape (TVT). Methods From September 2003 to December 2004, 40 cases of female stress urinary incontinence were treated, including 8 cases in association with cystocele or rectocele and 1 case in association with uterine prolapse. They ranged from 30 to 70 years in age with an average of 56.3years. The disease course was 1.42 years(7.2 years on average). All patients received TVT. In the patients suffering from uterine prolapse and cystocele or rectocele, butterfly-shaped mesh patch was applied. Results All patients achieved satisfactory results.The complications included slight dysuria(2 cases),vesical perforation(1 case) and pelvic hematoma(1 case) and cleared up after treating. All cases were followed up 1 to 15 months and the results were satisfactory. No urinary incontinence and no dysuria reoccurred. Conclusion TVT is effective for SUI.
目的探讨无张力疝修补术在双侧腹股沟疝中的临床应用价值。 方法1999年5月至2002年4月采用无张力疝修补术治疗双侧腹股沟疝25例，其中采用充填法18例, 双层补片5例, 一侧充填一侧双层补片2例。结果全组病例切口均一期愈合, 术后5~7 d出院，随访至今无复发。结论无张力疝修补术具有手术创伤小、痛苦少、术后恢复快等优点, 是治疗双侧腹股沟疝的最佳术式。
目的评价应用疝环充填式无张力疝修补术治疗腹股沟嵌顿疝并发小肠坏死的手术效果。方法对于我院2001年5月至2009年5月期间收治的21例腹股沟嵌顿疝并发小肠坏死患者应用疝环充填式无张力疝修补术给予一期修补，先行坏死肠管切除，后置入网塞。结果无手术死亡病例，1例患者发生切口感染，经换药后治愈。平均住院时间65 d。全部患者随访6个月至8年，平均51个月，未见复发。结论 疝环充填式无张力疝修补具有创伤小、安全及患者恢复快的优点，对于腹股沟嵌顿疝并发小肠坏死可以行一期修补，临床效果满意。
目的 了解局部麻醉下腹股沟疝无张力修补术后患者排便变化的相关影响因素。 方法 采用自行设计的问卷调查表，对2010年5月－6月行无张力修补术的腹股沟疝患者术后排便情况及变化进行调查，并就相关影响因素采用logistic回归方法进行统计分析。 结果 腹股沟疝无张力修补术后患者进食量减少、活动量减少、饮食成分变化、担心排便引起复发是术后排便变化的影响因素。 结论 加强该病症术后健康宣传，指导患者正常进食、多活动，消除患者对腹股沟疝复发的焦虑，可促进其早期排便。Objective To research on the risk factors for change of defecation after inguinal hernia mesh-repairs under local anesthesia. Methods Self-made questionnaires were used to investigate the defecation change among patients having undergone inguinal hernia mesh-repairs from May to June 2010, and the correlated factors for change of defecation were analyzed by logistic regression analysis. Results Reduction of activity and food, changes of food ingredients, and worries about recurrence were risk factors for change of defecation. Conclusion In order to facilitate the recovery of the patients, nurses should promote patients’ knowledge on the surgery, guide them to eat as usual and do more exercises, and eliminate their anxiety on recurrence of the disease.
Objective To evaluate the clinical effectiveness of laparoscopic and open tension-free hernia repairs in adults. Methods A fully recursive literature search was conducted in PubMed (2002 to September, 2009), EMBASE (2002 to September, 2009), Cochrane Central Register of Controlled Trials (Issue 3, 2009), CBM (2002 to September, 2009) , CNKI and VIP Chinese Scientific Journals Full-text Database (2002 to September, 2009) in any language. Randomized or quasi-randomized controlled trials of inguinal hernia treated by laparoscopic and open methods in adults were considered for inclusion. The four analyzed outcome variables were chronic pain, long term recurrence, intraoperative complications and postoperative complication. Data related to clinical outcomes were extracted by two reviewers independently. Statistical analyses were carried out using RevMan 5.0 software. Results Eighteen published reports of eligible studies involving 5816 participants met the inclusion criteria. Compared with open methods, laparoscopic inguinal hernia had no significant differences in long-term recurrence rate [OR 1.53, 95%CI (1.00 to 2.34), P=0.05] and postoperative complication rate [OR 0.74, 95%CI (0.52 to 1.05), P=0.09], and had lower tendency chronic pain [OR 0.45, 95%CI (0.34 to 0.59) , Plt;0.000 01] with statistical significance. There were significant differences in intraoperative complications between the two groups [OR 2.15, 95%CI (1.32 to 3.53), P=0.002]. Conclusion Current evidence suggests that laparoscopic hernia repair is superior to open methods in chronic pain .There is no significant difference in long-term recurrence rate and postoperative complications between the two methods. More studies are needed for intraoperative complications and other long-term postoperative complications.
目的 总结腹股沟疝无张力疝修补术的手术经验。方法 回顾性分析我院2002年2月至2009年1月期间126例腹股沟疝患者行无张力疝修补术的临床资料及手术方法。结果 本组126例患者无围手术期死亡者,并发症主要有局部肿胀、异物感、疼痛等,随访6个月～6年(平均38个月)有6例(4.8%)复发。结论 无张力疝修补术是治疗腹股沟疝较为理想的术式。
Objective To evaluate the clinical effect of Easy Prosthesis D-10 on open preperitoneal groin tension-free hernioplasty. Methods The operative time, operation-correlated complications, hospital stay and recent follow-up findings of 63 patients underwent preperitoneal groin tension-free hernioplasty were analyzed from October 2006 to April 2008. Results No case died in perioperative period. The average operative time was (47.6±10.5) minutes. None of incision infection and scrotal hydrocele occurred. The average hospital stay was (7.7±2.1) days. During follow-up period of 6 to 24 months, no recurrence, chronic pain and foreign body sensation were found. Conclusion The open preperioneal groin tension-free hernioplasty by Easy Prosthesis D-10 is safe and reliable, especially for the inguinal hernia with large hernia ring or defect of transversalis fascia and recurrent hernia.