3D补片联合腹腔镜经腹膜前疝修补术治疗腹股沟疝对患者疼痛程度及术后复发情况的影响

Effect of laparoscopic transabdominal preperitoneal hernia repair with 3D mesh on postoperative pain and recurrence

目的探究3D补片联合腹腔镜经腹膜前疝修补术(TAPP)治疗腹股沟疝对患者疼痛程度及术后复发情况的影响。方法选取自2016年9月至2017年12月于新疆医科大学第一附属医院普通外科进行手术治疗的70例腹股沟疝患者,根据术中所用补片不同,分为3D组(35例)及普通组(35例),所有患者均行TAPP进行治疗。其中3D组患者所用补片为美国巴德-3DMAX疝气补片,普通组患者所用补片为美国柯惠(泰科)疝气修补片,为普通补片。观察并比较2组患者的手术指标、术后疼痛视觉模拟量表评分(VAS)、术后并发症及复发情况。结果2组手术时间、术后住院天数、术中出血量比较,差异无统计学意义(P>0.05);3D组手术相关费用、术后下床活动时间均小于普通组(P<0.05)。术后即刻、术后12 h、术后30 d,2组患者的VAS评分差异无统计学意义(P>0.05);术后24 h、72 h、7 d、15 d,3D组患者的VAS评分均低于普通组,差异具有统计学意义(P<0.05)。术后12、24、72 h,2组患者的VAS评分均较术后即刻升高,差异具有统计学意义(P<0.05);术后7、15、30 d,2组患者的VAS评分均较术后即刻降低,差异具有统计学意义(P<0.05)。2组患者术后并发症差异无统计学意义(P>0.05),且均未复发。结论TAPP术是一种安全有效的手术方式,联合使用3D补片则可简化手术操作,降低患者术后疼痛,疗效可靠,值得临床推广应用。

Objective To explore the effect of laparoscopic transabdominal preperitoneal hernia repair(TAPP)with 3D mesh on the pain degree and postoperative recurrence of inguinal hernia.Methods Seventy patients with inguinal hernia who underwent surgery in the First Affiliated hospital of Xinjiang Medical University from September 2016 to December 2017 were divided into the 3D mesh group(n=35)and the ordinary mesh group(n=35)according to the different meshes used during surgery.All patients were treated with TAPP.Among them,the mesh used in the 3D group was Bard-3DMAX hernia mesh,while the mesh used in the ordinary mesh group was Covidien(Tyco)hernia mesh.The operation indexes,postoperative pain visual analog scale(VAS),complications and recurrence of the two groups were observed and compared.Results There were no significant differences in operation time,hospital stay and intraoperative bleeding between the two groups(P>0.05).The operation-related expenses and the time of getting out of bed after operation in the 3D group were less than those in the ordinary mesh group(P<0.05).There was no significant difference in the score of VAS between the two groups immediately,at 12 hours and 30 days after operation(P>0.05).The score of VAS in the 3D group was lower than that in the ordinary mesh group at 24 hours,72 hours,7 days and 15 days after operation(P<0.05).At 12 hours,24 hours and 72 hours after operation,the score of VAS in the two groups were higher than those immediately after operation(P<0.05);at 7 days,15 days and 30 days after operation,the score of VAS in the two groups were lower than those immediately after operation(P<0.05).There was no significant difference in postoperative complications and recurrence rate between the two groups(P>0.05).Conclusion TAPP is a safe and effective surgical method.The use of 3D mesh can simplify the operation,reduce the postoperative pain of patients,and has reliable curative effect.It is worthy of clinical application.