ProGrip^(TM)自固定补片和UHS补片在腹股沟疝无张力疝修补术中的对比研究

Randomized controlled trial comparing self-gripping mesh(Progrip^(TM))and ULTRAPRO Hernia System(UHS)in tension-free repair of inguinal hernia

目的比较ProGrip^(TM)自固定补片和UHS补片行无张力疝修补术治疗腹股沟疝效果的差异。方法选取2015年1月至2017年6月成都市双流区第一人民医院收治成人腹股沟疝患者300例,采用数字表法随机分为ProGrip^(TM)自固定补片组150例和UHS补片组150例。患者术后随访6~24个月,对2组手术前后临床数据、临床效果及术后并发症发生情况进行分析比较。结果2组患者术后1 d、1周、1个月视觉模拟评分法(VAS)比较,差异无统计学意义(P>0.05);术后3、6个月VAS比较,差异有统计学意义(P<0.05);慢性疼痛发生率比较,差异有统计学意义(P<0.05);ProGrip^(TM)自固定补片组平均手术时间、住院时间短于UHS补片组,差异有统计学意义(P<0.05);2组住院费用差异无统计学意义(P>0.05)。ProGrip^(TM)自固定补片组未出现异物感、切口感染、切口血肿和血清肿;术后阴囊积液1例,复发1例,慢性疼痛8例。UHS补片组出现术后异物感12例,切口感染2例,切口血肿和血清肿3例,阴囊积液7例,复发1例,慢性疼痛27例。结论应用ProGrip^(TM)自固定补片可降低腹股沟疝患者行无张力疝修补术后的慢性疼痛等并发症,值得临床推广。

Objective To compare the differences between ProGrip^(TM)self-gripping mesh and Ultrapro hernia system(UHS)repair in the treatment of inguinal hernia.Methods From January 2015 to July 2017,300 adult patients with inguinal hernia from Shuangliu district first people's hospital were enrolled.They were randomly divided into ProGrip^(TM)self-gripping mesh group and UHS repair group,with 150 cases in each group.The patients were followed up for 6 to 24 months.The clinical data,clinical effect and postoperative complications of the two groups were analyzed and compared.Results No statistical differences had been found in the comparison of pain score at 1 day,1 week,or even 1 month after operation(P>0.05).However,the difference compared between the two groups was significant at 3 and 6 months after operation(P<0.05).Another statistical difference in the incidence of chronic pain was significant from the comparison between the ProGrip^(TM)self-gripping mesh group and the UHS repair group(P<0.05).The average operation time and hospital stay in the ProGrip^(TM)self-gripping mesh group were shorter than those in the UHS group(P<0.05).There was no significant difference in hospitalization expenses between the two groups(P>0.05).There was no foreign body sensation,incision infection,incision hematoma and edema occurred in the ProGrip^(TM)self-gripping mesh group;in the ProGrip^(TM)self-gripping mesh group,scrotal effusion occurred in 1 case,recurrence in 1 case,and chronic pain in 8 cases.In the UHS group,foreign body sensation occurred in 12 cases,incisional infection in 2 cases,incision hematoma and serum swelling in 3 cases,scrotal effusion in 7 cases,recurrence in 1 case,chronic pain in 27 cases.Conclusion The chronic pain and other complications can be reduced with the ProGrip^(TM)self-gripping mesh in the treatment of patients with inguinal hernia.It is worth the clinical promotion.