免缝合自固定补片与普通补片在老年腹股沟斜疝患者手术治疗中的比较

Comparison of Non-sutured Self-fixating Mesh and Normal Mesh in the Surgical Treatment of Elderly Patients with Indirect Inguinal Hernia

目的:观察比较免缝合自固定补片与普通补片治疗老年腹股沟斜疝的临床效果。方法:选取2015年6月-2017年11月本院收治的男性老年腹股沟斜疝患者80例作为研究对象,按照随机数x~表法将其分为观察组和对照组,各40例。观察组采用免缝合自固定补片,对照组采用普通聚丙烯补片,比较两组术中出血量、手术及住院时间、术后30 d疼痛评分、并发症以及疝复发情况。结果:观察组术中出血量为(9.3±2.1)mL、手术时间为(39.4±5.1)min、住院时间为(4.3±1.3)d,均明显少于对照组的(14.4±2.8)mL、(57.2±6.1)min及(6.9±0.8)d,差异均有统计学意义(P<0.01)。术后30 d,两组患者的VAS评分较术前均显著降低,且观察组明显低于对照组,差异均有统计学意义(P<0.05)。观察组术后并发症发生情况明显低于对照组,差异有统计学意义(x^2=4.114,P=0.043)。术后3个月,观察组无疝复发;对照组有4例疝复发,复发率为10.0%。两组疾病复发情况比较,差异有统计学意义(x^2=4.211,P=0.040)。结论:免缝合自固定补片治疗老年腹股沟斜疝疗效确切,可获得满意的临床疗效,值得临床推广应用。

Objective:To observe and compare the clinical effect of non-sutured self-fixating mesh and normal mesh in treatment of elderly patients with indirect inguinal hernia.Method:A total of 80 elderly patients with indirect inguinal hernia admitted in our hospital from June 2015 to November 2017 were selected as the study objects.According to the random number table method,they were divided into observation group and control group,40 cases in each group.The observation group was treated with non-sutured self-fixating mesh,the control group was treated with normal polypropylene mesh.The intraoperative bleeding volume,operation and hospitalization time,postoperative 30-day pain score,complications and hernia recurrence between the two groups were compared.Result:The amount of intraoperative bleeding in the observation group was(9.3±2.1)mL,the operation time was(39.4±5.1)min and the hospitalization time was(4.3±1.3)d,which were significantly less than(14.4±2.8)mL,(57.2±6.1)min and(6.9±0.8)d respectively in the control group,the differences were statistically significant(P<0.01).After operation 30 days,VAS scores of the two groups were significantly lower than those before operation,and the observation group was significantly lower than that in the control group,the differences were statistically significant(P<0.05).The incidence of postoperative complications in the observation group was significantly lower than that in the control group,the difference was statistically significant(χ2=4.114,P=0.043).After operation 3 months,there was no recurrence of hernia in the observation group.In the control group,there were 4 cases of recurrence of the hernia,the recurrence rate was 10.0%.The recurrence rate of the two groups was statistically significant(χ2=4.211,P=0.040).Conclusion:Non-sutured self-fixating mesh in the treatment of elderly patients with indirect inguinal hernia curative effect is exact,can obtain satisfactory clinical effect,which is worthy of clinical promotion and application.