3D Max标准型补片和轻量型补片在腹腔镜经腹腹膜前疝修补术中应用的对照研究

Efficacy Comparison of 3D Max Lightweight Patch and Standard Patch in Laparoscopic Transabdominal Preperitoneal Herniorrhaphy

目的比较3D Max标准型补片和轻量型补片在腹腔镜经腹腹膜前疝修补(TAPP)术中临床应用的安全性、有效性及稳定性。方法回顾性分析2013年5月至2014年5月期间我院在全麻下施行的3D Max补片腹腔镜TAPP术147例患者的临床资料,其中轻量型补片组75例(观察组),标准型补片组72例(对照组),比较2组患者的平均手术时间、术中出血量、术后早期离床活动时间、术后疼痛、并发症、平均住院时间及平均住院费用。采用视觉模拟评分法(VAS)对术后第2 d、第1个月和第6个月时的疼痛情况进行评分,并以此判断术后腹股沟区是否仍有异物感。结果观察组和对照组的平均手术时间、平均术后离床活动时间、平均术中出血量、平均住院时间及平均住院费用比较差异均无统计学意义(P>0.05)。术后2 d时,观察组的术后疼痛评分略低于对照组,但2组间比较差异无统计学意义(P=0.132),术后1个月及术后6个月时,观察组的术后疼痛评分明显低于对照组,差异有统计学意义(P=0.031、P=0.018)。2组均无并发症及疝复发。结论 3D Max轻量型补片在腹腔镜TAPP术中的应用价格稍高于标准型补片,但其能够减轻术后疼痛,减少术后异物感,使患者感觉更加舒适,且在临床应用安全、有效且较为稳定。

Objective To compare the safety,effectiveness,and stability of 3D Max lightweight patch and standard patch in laparoscopic transabdominal preperitoneal（TAPP） herniorrhaphy.Methods The clinical data of 147 patients who underwent laparoscopic TAPP herniorrhaphy with 3D Max from May 2013 to May 2014 in this hospital were collected.Of all the patients,the lightweight patches were used in 75 patients（observation group）,the standard patches were used in 72patients（control group）.The mean operative time,mean early postoperative ambulation time,mean bleeding volume,postoperative pain,postoperative foreign body sensation,complications,average hospital stay,and average costs were compared between these two groups.The postoperative pain point was determined by using visual analogue scale（VAS）.The foreign body sensation of postoperative groin area was determined basing on the pain point.Results There were no significant differences in the terms of the mean operation time,the mean early postoperative ambulation time,the mean bleeding volume,the average costs,and the average hospital stay between the observation group and the control group（P〈0.05）.On postoperative 2 d,the pain point of the observation group was slightly lower than that of the control group,but there was no statistically significant difference between these two groups（P=0.132）;On postoperative 1 month and 6 months,the postoperative pain points of the observation group were significantly lower than those of the control group,the differences were statistically significant（P=0.031,P=0.018）.There was no recurrence of hernia and complications in the two groups.Conclusions The cost of 3D Max lightweight patch in laparoscopic TAPP herniorrhaphy application is slightly higher than that in standard patch,but it could alleviate postoperative pain,reduce postoperative foreign body sensation,and make patients feel more comfortable.It is safe,effective,and stable in clinical application of laparoscopic TAPP herniorrhaphy.