轻型聚丙烯补片与标准型聚丙烯补片在腹股沟疝无张力修补术中应用的对比研究

The controlled study of application with light and standard polypropylene mesh in tension-free repair of inguinal hernia

目的对比分析轻型聚丙烯补片与标准型聚丙烯补片在腹股沟疝无张力修补术中的应用价值。方法实验组使用轻型聚丙烯补片,对照组使用标准型聚丙烯补片,每组各30例患者。记录两组患者手术前后的临床参数及术后各种并发症的发生例数,并对数据进行统计学分析。结果经统计分析,两组患者在手术时间、术后的最高体温、术后住院日数、术后C-反应蛋白升高的例数以及术前与术后24 h的血白细胞计数、中性粒细胞分类计数和生化的谷丙转氨酶、谷草转氨酶、尿素氮、肌酐的数值等方面均无显著性差异。术后随访6个月,两组均未出现伤口感染、复发、男性患者的睾丸肿大/萎缩。实验组术后有2例出现阴囊积液,1例出现慢性疼痛,没有局部异物感发生;对照组术后有3例发生阴囊积液,3例出现慢性疼痛,6例出现局部异物感。经统计学分析,两组除局部异物感的发生率有显著性差异(P<0.05)外,其它并发症方面的差异无统计学意义。结论轻型聚丙烯补片在腹股沟疝无张力修补术中的应用是安全有效的;由于其轻质轻量、大网孔、高弹性的特点,可减少术后局部异物感的发生。

Objective To evaluate the effect of light polypropylene mesh in tension-free repair of inguinal hernia initially, by the controlled study of application with light and standard polypropylene mesh in herniorrhaphy. Methods A total of 60 patients were divided into 2 groups to receive light polypropylene mesh （experiment group） or standard polypropylene mesh （control group） repair procedure. Data collected included ： operation time, postoperative highest temperature and the day of hospital stay ; leucocyte count and differential count, the count of CRP, AST, ALT, BUN, Cr in preoperative and postoperative 24 hours; the cases of postoperative complications including wound infection, recurrence, testicular swelling or atrophy, scrotal hydrocele, chronic pain and foreign body feeling. The data were analyzed by statistical method. Results By the statistical analysis, no significant differences were found between the two groups in the operation time, postoperative highest temperature, the day of hospital stay, and the cases of elevated count in postoperative CRP; no significant differences in the leucocyte count, differential count, and the count of AST, ALT, BUN, Cr in preoperative and postoperative 24 hours. During the follow up period of 6 months, there was no wound infection, recurrence, testicular swelling or atrophy in the two groups ; There were 2 cases of scrotal hydrocele and 1 case of postoperative chronic pain in experiment group, there were 3 cases of scrotal hydrocele and 3 cases of postoperative chronic pain in control group, by the statistical analysis, no significant differences were found between the two groups ; There were 6 patients complained of foreign body feeling in control group, but no one in experiment group, which is statistical significant （ P 〈 0. 05 ）. Conclusions The application with light polypropylene mesh in tension-free herniorrhaphy is safe and effective. It should diminish the incidence of postoperative foreign body feeling due to the feature of light quality, high porosity and excellent flexibility.