传统聚丙烯和聚酯补片修补腹股沟疝对患者疼痛及血浆超氧化物歧化酶、丙二醛水平影响的比较

Polypropylene versus polyester patches for inguinal hernia repair:pain relief and changes in plasma superoxide dismutase and malondialdehyde levels

背景:聚酯及聚丙烯补片是腹股沟疝修补常用的补片材料,两种材料有各自的特点。目的:观察不同材质补片修复后男性腹股沟疝患者血浆超氧化物歧化酶、丙二醛水平以及疼痛变化,以期为补片选择提供一定的参考。方法:纳入120例男性腹股沟疝患者,分3组治疗(n=40),对照组进行传统的疝修复手术;聚丙烯补片组及聚酯补片组进行无张力疝修补手术,分别植入聚丙烯补片与聚酯补片。记录手术时间、补片固定时间、住院时间、拔出尿管时间、下床活动时间;修复前及修复后12,24,48,72 h,采用目测类比评分评估患者疼痛情况;修复前及修复后1,2,7 d,检测患者血浆超氧化物歧化酶及丙二醛水平。结果与结论:(1)聚酯补片组、聚丙烯补片组手术时间短于对照组(P<0.05);聚酯补片组、聚丙烯补片组住院时间、下床活动时间短于对照组(P<0.05);3组间拔出尿管时间比较差异无显著性意义;两补片组补片固定时间比较差异无显著性意义;(2)修复后12,24,48,72 h,3组目测类比评分均较修复前显著降低(P<0.05),3组间比较差异无显著性意义;(3)术后1,2,7 d,聚酯补片组超氧化物歧化酶水平低于聚丙烯补片组(P<0.05);(4)术后1,2,7 d,聚酯补片组、聚丙烯补片组丙二醛水平高于对照组(P<0.05),聚酯补片组丙二醛水平高于聚丙烯补片组(P<0.05)。(5)结果说明,传统疝修复与无张力疝修复均可明显缓解男性腹股沟疝患者的疼痛,补片植入能够影响腹股沟疝患者血浆超氧化歧化酶、丙二醛水平,但聚丙烯补片的影响较小。

BACKGROUND： Polyester and polypropylene patches are commonly used patch materials for inguinal hernia repair. Both of them have their own characteristics.OBJECTIVE： To observe and compare the effects of different patches on plasma superoxide dismutase and malondialdehyde levels as well as pain relief in male inguinal hernia patients. METHODS： One hundred and twenty male patients with inguinal hernia were divided into three groups（n=40 per group）： a control group treated with traditional hernia repair surgery, a polypropylene patch group and a polyester patch group treated with tension-free hernia repair using polypropylene or polyester patches. Operation time, hospitalization time, patch fixation time, time for urinary catheter removal, and bed time were recorded. Visual Analogue Scale was used for pain assessment before and 12, 24, 48, 72 hours after repair. Plasma levels of superoxide dismutase and malondialdehyde were detected before and 1, 2, 7 days after repair. RESULTS AND CONCLUSION： Compared with the control group, the operation time, hospitalization time and bed time were shorter in the polyester and polypropylene patch groups（P〈0.05）, but there was no significant difference in the time for removal of urinary catheters among the three groups. Moreover, there was also no significant difference in the patch fixation time between the two patch groups. The Visual Analog Scale scores in the three groups were all significantly decreased at 12, 24, 48, 72 hours after repair with the baseline data（P〈0.05）, while there was no significant difference among the three groups. At postoperative 1, 2, 7 days, the plasma level of superoxide dismutase was significantly lower in the polyester patch group than the polypropylene patch group（P〈0.05）, while the level of malondialdehyde was ranked as follows： polyester patch group polypropylene patch group control group（P〈0.05）. These findings indicate that both traditional hernia repair and tension-free hernia repair can significantly relieve the pain of male inguinal hernia patients. Patch implantation can change the plasma levels of superoxide dismutase and malondialdehyde in patients with inguinal hernia; in contrast, the polypropylene patch only results in a little effect on the levels.