自固定补片和生物补片在腹股沟疝术后疼痛的临床对照研究

Clinical control trial comparing self-gripping mesh with biologic prosthetic material in postoperative pain after open inguinal herniorrhaphy

目的探讨自固定补片和生物补片在腹股沟疝无张力修补术后疼痛情况对比。方法回顾性分析2014年5月至2016年12月复旦大学附属华东医院疝与腹壁外科治疗与培训中心收治的行开放腹股沟疝无张力修补术治疗患者的临床资料,将成年男性初发单侧疝择期手术病例按照植入补片分为试验组209例和对照组142例。结果试验组患者在术后1周VAS评分(19±16)分较对照组(24±18)分明显降低,差异有统计学意义(P=0.000),而在术前,术后1、3个月VAS评分2组比较差异无统计学意义,试验组患者术后补救镇痛率、出院带止痛药率显著性降低。结论应用自固定补片于成人开放式腹股沟疝无张力修补术能减少术后早期疼痛。

Objective The aim of this study was to evaluate postoperative pain after open inguinal herniorrhaphy using self-gripping mesh compared with biological prosthetic material. Methods We reviewed patients who had open inguinal tension-free herniorrhaphy in Huadong Hospital Affiliated to Fudan University from May 2014 to December 2016. All adult male patients with primary unilateral inguinal hernia were divided into treatment group 209 cases and control group 142 cases according to type of implantation. Results The visual analog scale pain score （VAS） showed at the first postoperative week a significantly lower level in treatment group than control group [ （ 19 ± 16） vs （ 24 ± 18 ）, P = 0. 000 ], but no statistical significance between two groups at one month and three months. The rate of postoperative remedial analgesia and discharge medication were all lower in the treatment group. Conclusion Self-gripping mesh used in aduh open inguinal herniorrhaphy seems to be with less early postoperative pain.