持续负压引流在腹股沟疝平片式无张力疝修补术中的应用效果

Application effect of continuous vacuum sealing drainage in patch tension-free hernioplasty for inguinal hernia

目的评价持续负压引流在腹股沟疝平片式无张力疝修补术中的应用效果。方法纳入涪陵区中医院接受平片式无张力疝修补术的162例单侧腹股沟疝患者,将其随机分为引流组(n=75)和非引流组(n=87)。比较2组患者术后24 h、48 h、72 h的白细胞计数、中性粒细胞比值、视觉模拟评分法(VAS)评分,比较2组术后住院时间及术后并发症(切口愈合不良、血清肿、切口感染)发生率,记录引流组患者术后拔管时间、引流量。结果引流组患者术后24 h、48 h、72 h白细胞计数少于非引流组,差异有统计学意义(P<0.05)。引流组患者术后24 h、48 h中性粒细胞比值低于非引流组,差异有统计学意义(P<0.05);2组患者术后72 h中性粒细胞比值比较,差异无统计学意义(P>0.05)。引流组术后24 h、48 h、72 h VAS评分与非引流组比较差异无统计学意义(P>0.05)。2组术后住院时间比较,差异无统计学意义(P=0.914)。引流组术后并发症发生率低于非引流组,差异有统计学意义(P=0.038)。引流组术后平均拔管时间为3.57 d,平均引流量为103 m L。结论持续负压引流可减轻平片式无张力疝修补术后炎症反应,降低术后并发症发生率,且不会增加术后疼痛,有良好的临床应用效果。

Objective To evaluate the application effect of continuous vacuum sealing drainage in patch tension-free hernioplasty for inguinal hernia.Methods A total of 162 patients with unilateral inguinal hernia who underwent patch tension-free hernioplasty in Traditional Chinese Medicine Hospital of Fuling were included,and they were randomly divided into the drainage group(n=75)and the non-drainage group(n=87).The white blood cell counts,neutrophil ratios,and visual analogue scale(VAS)scores at 24 hours,48 hours,and 72 hours after operation,postoperative hospital stay,and incidence of postoperative complications(poor incision healing,seroma,incision infection)were compared between the two groups.The extubation time and drainage volume after surgery of the patients in the drainage group were recorded.Results The white blood cell counts at 24 hours,48 hours,and 72 hours after surgery in the drainage group were lower than those in the non-drainage group,with statistically significant differences(P<0.05).The neutrophil ratios in the drainage group at 24 hours and 48 hours after surgery were lower than those in the non-drainage group,with statistically significant differences(P<0.05).There was no statistically significant difference in the neutrophil ratios at 72 hours after surgery between the two groups(P>0.05).There was no statistically significant difference in the VAS scores at 24 hours,48 hours or 72 hours after surgery between the drainage group and the non-drainage group(P>0.05).There was no statistically significant difference in the postoperative hospital stay between the two groups(P=0.914).The incidence of postoperative complications in the drainage group was lower than that in the non-drainage group,with statistically significant difference(P=0.038).In the drainage group,the average postoperative extubation time was 3.57 days,and the postoperative average drainage volume was 103 m L.Conclusion The continuous vacuum sealing drainage can alleviate the inflammatory reaction after patch tension-free hernioplasty,reduce the incidence of postoperative complications,and will not increase the postoperative pain,which has a good clinical application effect.