腹腔镜经腹腹膜前疝修补术中应用自固定补片对巨大腹股沟疝患者治疗效果

Effect of self-gripping mesh on patients with giant inguinal hernia during laparoscopic transabdominal preperitoneal hernia repair

目的探究腹腔镜经腹腹膜前疝修补术(TAPP)术中应用自固定补片对巨大腹股沟疝患者的疼痛效果。方法选择2015年5月至2018年5月,上海交通大学医学院附属第九人民医院行腹腔镜经腹腹膜前疝修补术的巨大腹股沟疝患者100例,按术中补片固定方式其分为试验组(50例)和对照组(50例),其中试验组采用自固定补片,对照组采用钉合固定补片。比较2组患者围术期各项指标,术后并发症,以及术后24 h、1周、1、3、6、12个月的疼痛状况;并记录2组患者补救镇痛情况。结果试验组的住院时间和住院费用均低于对照组(P<0.05)。术后24 h、1周、1、3、6个月,试验组的VAS评分均低于对照组(P<0.05)。试验组术后补救镇痛例数和出院带止痛药例数均少于对照组(P<0.05)。试验组的晚期并发症发生率为0,低于对照组8%(P<0.05)。结论TAPP术中应用自固定补片不仅可以减少患者的住院时间和住院费用,还可以缓解患者术后疼痛,降低补救镇痛情况及晚期并发症。

Objective To explore the effect of self-gripping mesh on patients with huge inguinal hernia during laparoscopic transabdominal preperitoneal hernia repair.Methods One hundred patients with huge inguinal hernia who underwent laparoscopic transabdominal preperitoneal hernia repair in the Ninth people's hospital of Shanghai Jiaotong University School of Medicine from May 2015 to May 2018 were selected as the research objects,and they were divided into the experimental group(n=50)according to the method of intraoperative mesh fixation and the control group(n=50).The experimental group used self-gripping mesh and the control group used tack fixation mesh.The perioperative indicators,postoperative complications,and pain status at 24 h,1 week,1 month,3 months,6 months,and 12 months after operation were compared between the two groups of patients.Results The length of hospitalization and hospitalization expenses of the experimental group were lower than those of the control group(P<0.05).At 24 h,1 week,1 month,3 months,6 months after operation,the VAS scores of the experimental group were lower than those of the control group(P<0.05).The number of postoperative salvage analgesia and the number of patients discharged with analgesics in the experimental group were less than those in the control group(P<0.05).The incidence of late complications in the experimental group was 0,which was lower than 8%in the control group(P<0.05).Conclusion The application of self-gripping mesh during laparoscopic transabdominal preperitoneal hernia repair can not only reduce the patient's hospital stay and hospital costs,but also relieve postoperative pain,reduce salvage analgesia and late complications.