ProGrip型与UHS型补片在相应术式下治疗腹股沟疝的临床研究

Clinical comparative study of ProGrip and UHS mesh in the treatment of inguinal hernia under the corresponding operation

目的对比分析应用ProGrip自固定型补片行Lichtenstein术与应用UHS型补片行腹膜前间隙无张力修补术(Gilbert)治疗腹股沟疝的临床效果。方法回顾性分析自2015年9月至2017年8月,山西医科大学第二医院150例男性腹股沟疝患者的临床资料,按所采用的手术方法和补片类型分为2组,每组75例。A组选用美国柯惠公司生产的ProGrip自固定型补片+Lichtenstein术,B组选用美国强生公司生产的UHS型补片+Gilbert术。结果 A组手术时间短于B组,术后慢性疼痛发生情况高于B组,异物感发生情况低于B组,差异均有统计学意义(t=30.21、χ~2=5.37、11.04,P<0.05);2组住院时间比较,差异无统计学意义(P>0.05);术后2组患者均无感染,随访3个月均无复发。结论两种不同补片及对应术式治疗腹股沟疝都有良好的近期效果,应用ProGrip自固定型补片行Lichtenstein术在缩短手术时间、减少术后异物感方面有一定优势,且具有简单易操作的特点;应用UHS型补片行Gilbert术在理论上更符合人体力学,且在预防术后慢性疼痛方面有一定优势,但操作相对复杂,术式学习曲线相对较长。

Objective To compare the clinical effect between Lichtenstein operation with ProGrip self-gripping mesh and anterior preperitoneal tension-free repair with UHS mesh(Gilbert operation) in the treatment of inguinal hernia. Methods A retrospective analysis of 150 male cases of inguinal hernia who were admitted to the second hospital of Shanxi medical university from September 2015 to August 2017 were enrolled. All the patients were divided into two groups according to the operation method and the types of mesh, 75 cases in each group. The patients in group A were treated by Lichtenstein operation with ProGrip self-gripping mesh(Covidien?, US). The patients in group B were treated with anterior preperitoneal tension-free repair with UHS mesh(Johnson&Johnson?, US). Results In the two groups, operation time, postoperative incidence of chronic pain and foreign body sensation were statistically significant(t=30.21 、 χ~2=5.37 、 11.04, P<0.05). There was no significant difference in hospitalization time(t=0.98, P>0.05). There was no infection and recurrence in the period of 3 months of follow-up. Conclusions Both the two different meshes and the corresponding treatment of inguinal hernia have good short term effect, the application of Lichtenstein operation with ProGrip self-gripping mesh has certain advantages in the prevention of postoperative incidence of foreign body sensation and shortening the operation time, and it’s easy to perform. In theory, anterior preperitoneal tension-free repair with UHS patch is more in line with human mechanics, and has certain advantages in preventing postoperative chronic pain, but it is relatively complicated and the operation learning curve is relatively long.