脱细胞基质生物补片在腹腔镜腹股沟斜疝修补中的应用

Application of Acellular Matrix Mesh in Laparoscopic Indirect Inguinal Hernia Repair

目的探讨脱细胞基质生物补片在腹腔镜腹股沟斜疝修补术中的应用价值。方法选取单测腹股沟斜疝患者110例为研究对象,依据随机数字表法分为观察组和对照组,各55例。观察组采用脱细胞基质生物补片修补术治疗,对照组采用聚丙烯补片修补术治疗。比较2组患者的手术相关指标、术后1周及6个月随访指标。结果观察组手术时间长于对照组[(45.45±10.49)min vs(39.53±10.14)min],差异有统计学意义(P<0.05);观察组手术费用高于对照组[(2.21±0.51)万元vs(1.89±0.53)万元],差异有统计学意义(P<0.05)。术后随访1周,对照组阴囊血清肿发生率(27.27%)及睾丸肿胀发生率(25.45%),高于观察组(9.09%,10.91%),差异均有统计学意义(P<0.05)。术后随访6个月,观察组疼痛评分、腹股沟慢性疼痛发生率及精索疼痛发生率均优于对照组[(0.35±0.02)分vs(0.38±0.03)分;3.6%vs 16.4%;5.4%vs 18.2%],差异有统计学意义(P<0.05)。术后6个月均无复发患者。结论采用脱细胞基质生物补片行腹腔镜腹股沟斜疝修补术安全可靠,虽手术费用稍高,但可有效降低术后慢性疼痛的发生率。

Objective To investigate the value of acellular matrix mesh in laparoscopic indirect inguinal hernia repair.Methods A single test of 110 patients with indirect inguinal hernia were selected as the research object,and the random number table method was divided into observation group and control group,55 cases in each group.The observation group was treated with acellular matrix biological patch repair,and the control group was treated with polypropylene patch repair.The surgery-related indicators and the follow-up indicators for 1 week and 6 months after the operation were compared between the two groups of patients.The surgery-related indicators and the follow-up indicators for 1 week and 6 months after the operation were compared between the two groups of patients.Results The operation time of the observation group was longer than that of the control group[(45.45±10.49)min vs(39.53±10.14)min],the difference was statistically significant(P<0.05);the operation cost of the observation group was higher than that of the control group[(2.21±0.51)]ten thousand yuan vs(1.89±0.53)ten thousand yuan,the difference was statistically significant(P<0.05).After 1 week of follow-up,the incidence of scrotal seroma(27.27%)and testicular swelling(25.45%)in the control group were higher than those in the observation group(9.09%,10.91%),and the differences were statistically significant(P<0.05).Follow-up for 6 months after surgery,the pain score,incidence of chronic groin pain and the incidence of spermatic cord pain in observation group were better than those in the control group[(0.35±0.02)points vs(0.38±0.03)points;3.6%vs 16.4%;5.4%vs 18.2%],the difference was statistically significant(P<0.05).There were no patients with recurrence 6 months after operation.Conclusion The use of acellular matrix mesh for laparoscopic indirect inguinal hernia repair is reliable and safe.Although it increases the operation cost,it can effectively reduce the incidence of postoperative chronic pain.