不同补片固定方式对Ⅰ和Ⅱ型腹股沟疝腹腔镜经腹腹膜前疝修补术疗效对比分析

Comparative study on the effect of different patch fixation methods on type Ⅰ and Ⅱ inguinal hernia laparoscopic preperitoneal hernia repair

目的对比不同补片固定方式对Ⅰ、Ⅱ型腹股沟疝腹腔镜经腹腹膜前疝修补术疗效的影响。方法选择2018-02-01-2020-03-14在浚县新镇中心卫生院行腹股沟疝腹腔镜经腹腹膜前疝修补术的Ⅰ、Ⅱ型腹股沟疝患者78例进行前瞻性研究。采用组间匹配的方法将患者分为2组,每组各39例。对照组以螺钉固定补片,观察组以可吸收缝线缝合固定补片。比较2组患者手术一般情况、疼痛、炎症因子及并发症发生情况。结果两组患者手术时间[(92.84±21.08)min vs(90.59±22.17)min]、术后住院时间[(2.41±0.61)d vs(2.50±0.69)d]和术中出血量[(12.09±2.94)mL vs(12.51±3.02)mL],差异均无统计学意义,均P>0.05。术前两组患者VAS得分[(1.28±0.31)分vs(1.25±0.29)分]差异无统计学意义,t=0.861,P>0.05;术后24和48h观察组VAS得分分别为(3.57±1.49)分和(2.42±0.48)分,均低于对照组的(4.52±1.62)分和(3.17±1.09)分,差异有统计学意义(t=5.255,P<0.05;t=7.577,P<0.05)。术前两组C反应蛋白[(3.98±1.27)ng/L vs(3.85±1.33)ng/L]及白细胞介素-6[(12.31±2.86)ng/L vs(11.98±2.91)ng/L]差异均无统计学意义(t=0.863,P>0.05;t=0.987,P>0.05),术后观察组C反应蛋白[(7.94±2.03)ng/L]及白细胞介素-6[(15.59±3.95)ng/L]均低于对照组的(9.31±2.61)ng/L和(18.62±4.71)ng/L,差异均有统计学意义(t=5.028,P<0.05;t=5.991,P<0.05)。对照组共出现2例(5.13%)并发症,观察组出现3例(7.69%)并发症,两组差异无统计学意义,P>0.05。结论可吸收缝线缝合补片较可吸收缝线缝合补片效果明显,可有效缓解Ⅰ、Ⅱ型腹股沟疝腹腔镜经腹腹膜前疝修补术患者疼痛,缓解炎症反应且具有较高的安全性。

Objective To compare the effects of different patch fixation methods on laparoscopic preperitoneal hernia repair for typeⅠandⅡinguinal hernia.Methods Totally 78 patients with typeⅠandⅡinguinal hernia who underwent laparoscopic preperitoneal hernia repair for inguinal hernia at the Xinzhen Central Health Center in Junxian County from February 1,2018 to March 14,2020 were selected for the study.The patients were divided into 2 groups by matching between groups,each with 39 cases.The control group used screws to fix the patch and fix the patch.The general conditions of surgery,pain,inflammatory factors and complications of the two groups were compared.Results There were no significant differences in operation time(92.84±21.08 vs 90.59±22.17)min,postoperative hospital stay(2.41±0.61 vs 2.50±0.69)days and intraoperative blood loss(12.09±2.94 vs 12.51±3.02)ml between the two groups(t=0.898,-1.195,-.216,P>0.05).The VAS scores of the two groups before operation(1.28±0.31 vs 1.25±0.29)were not statistically significant(t=0.861,P>0.05);the VAS scores of the observation group 24 hand 48 hafter operation were(3.57±1.49)and(2.42±0.48)respectively,which were lower than(4.52±1.62)and(3.17±1.09)of the control group(t=5.255,7.577,P<0.05).Before surgery,the two groups of C-reactive protein(3.98±1.27 vs 3.85±1.33)ng/L and interleukin-6(12.31±2.86 vs 11.98±2.91)ng/L,the difference was not statistically significant(t=0.863,0.987,P>0.05),after surgery C-reactive protein(7.94±2.03)ng/L and interleukin-6(15.59±3.95)ng/L in the observation group were significantly lower than those in the control group(9.31±2.61)ng/L and(18.62±4.71)ng/L(t=5.028,5.991,P<0.05).There were 2 cases(5.13%)in the control group and 3 cases(7.69%)in the observation group.There was no significant difference between the two groups(P>0.05).Conclusion Absorbable suture suture patch can effectively relieve the pain of patients undergoing laparoscopic preperitoneal hernia repair of typeⅠandⅡinguinal hernia compared with nail fixation,relieve inflammation and have higher safety.