不同腹膜前修补补片在成人腹股沟疝无张力修补术疗效中的对比研究

Comparative study of different preperitoneal repair meshes for the tension-free repair surgery of inguinal hernia in adults

目的比较善释·禧D10补片与善释D10补片在采用腹膜前间隙无张力修补术治疗成年人腹股沟疝的临床效果。方法选取2019年1月至2020年2月于贵州省六盘水市人民医院普外科行腹膜前间隙无张力疝修补术100例成年人腹股沟疝患者。按入院时间随机分为善释·禧D10补片组和善释D10补片组,每组各50例。评价2组患者术中情况及近远期疗效、并发症情况。结果 2组患者在手术中出血量、手术持续时间、术后首次下床活动时间、术后住院时间比较,差异无统计学意义(P>0.05);善释D10补片组住院费用小于善释·禧D10补片组(P<0.05);2组患者术后1周并发症发生率无差异(P>0.05);善释·禧D10补片组术后远期异物感发生率小于善释D10补片组(P<0.05);半年内随访善释·禧D10补片组慢性疼痛小于善释D10补片组(P<0.05);半年后随访慢性疼痛无差异(P>0.05);2组患者术后不同时间复发率无差异(P>0.05)。2组患者术后均无严重并发症发生,复发率、远期慢性疼痛及远期异物感发生率均较低,手术至随访期间患者均未出现严重疼痛和严重异物感。术后随访时间越长,患者的疼痛和异物感越弱。结论在行腹膜前间隙无张力疝修补术治疗成人腹股沟疝材料选择方面,善释·禧D10补片与善释D10补片均是安全、有效的修补材料;修补材料应根据患者情况个体化选择。

Objective To compare the clinical effect of partially absorbable good release mesh D10 and good release mesh D10 in the treatment of adult inguinal hernia by adopting tension-free preperitoneal space repair.Methods From January 2019 to February 2020,100 patients in the general surgical hernia repair group of Liupanshui City People's Hospital in Guizhou province were randomly selected to undergo tension-free hernia repair in the preperitoneal space.According to the time of admission,the patients were randomly divided into 50 cases of partially absorbable good release meshes D10 group and 50 cases of good release meshes D10 group.The two groups of patients were evaluated according to the intraoperative situation,short-term and long-term efficacy and complications.Results Two groups of patients in the intraoperative blood loss,duration of surgery,postoperative bed the first time,postoperative hospital stay,no significant difference(P>0.05).The good release meshes D10 group hospitalization costs less than the partially absorbable good release meshes D10 group(P<0.05).There was no difference in the incidence of complications 1 week after operation between the two groups(P>0.05).The incidence of long-term postoperative foreign body sensation in the partially absorbable good release meshes D10 group was lower than that in the good release meshes D10 group(P<0.05).Chronic pain was followed up for half a year in the partially absorbable good release meshes D10 group,which was smaller than the good release meshes D10 group(P<0.05).The difference in the follow-up after half a year of chronic pain was small(P>0.05),with no statistical significance.The recurrence rate of the two groups at different time after operation showed little difference(P>0.05),no statistical significance.Dividing into two group patients have no serious complications, and the recurrence rate and the forward have a lower incidence of chronic pain and long-term foreign body sensation, surgery and follow-up period, no serious pain and foreign body sensation occurred in both pain and foreign body sensation in patients. The longer the follow-up time, the weaker the pain and foreign body sensation. Conclusion In terms of the selection of materials in adult inguinal hernia in the treatment of tension-free preperitoneal hernia repair in the preperitoneal space, both partially absorbable good release meshes D10 and good release meshes D10 are safe and effective. Repair materials should be adopted the personalized selection according to the patient's condition.