日间疝修补术后不同加压方式对血清肿预防的差异研究

Differences in prevention of seroma after daytime hernia repair by different compression methods

目的探究日间腹股沟疝无张力修补术后使用新型疝穿戴装置(HWD)和传统压迫方法对术后血清肿预防效果及生活质量影响的差异,以期发现可有效降低术后血清肿发生率及提高患者生活质量的临床途径。方法选取四川省人民医院日间手术中心2022年12月至2023年8月收治的125例腹股沟疝患者,均行腹腔镜下腹股沟疝无张力修补术,采用随机数字表法将纳入样本的腹股沟疝患者随机分成试验组与对照组。试验组术后穿戴HWD压迫术区体表投影处,对照组术后用盐袋常规压迫。随访并分析2组术后血清肿发生情况、疼痛视觉模拟量表(VAS)评分,使用卡罗莱纳舒适量表(CCS)评估生活质量,并调查HWD的使用满意度。结果2组患者在年龄、性别、疝类型等一般术前资料方面差异无统计学意义(P>0.05)。共有122例完成术后1周随访,随访率97.6%。其中试验组血清肿发生率为8.3%(5/60),对照组血清肿发生率为21.0%(13/62),差异有统计学意义(P<0.05)。术后1、3个月2组血清肿发生率差异无统计学意义(P>0.05)。随着术后时间延长,2组患者VAS评分均逐渐降低,其中试验组在术后2 h VAS评分低于对照组(P<0.05),术后1周VAS评分差异无统计学意义(P>0.05)。术后1周,2组患者的CCS评分均处于较低水平,且试验组低于对照组(P<0.05)。术后1周评估,HWD应用的总体满意度为91.6%(55/60)。结论在日间腹股沟疝无张力修补术后使用HWD较传统盐袋压迫方法,可以更好地降低血清肿发生率,减轻术后疼痛,提高生活质量,患者使用满意度较高。

Objective To investigate the difference of a novel hernia wearable device(HWD)and traditional compression methods on postoperative seroma prevention and quality of life after inguinal hernia day surgery,and to identify an effective clinical approach for reducing seroma incidence and improve patient quality of life.Methods A total of 125 patients with inguinal hernia admitted to the day surgery center of Sichuan Provincial People's Hospital from December 2022 to August 2023 were selected.All patients underwent laparoscopic tension-free repair of inguinal hernia.The patients were randomly divided into experimental group and control group by random number table method.The experimental group utilized HWD for compression at the surgical site postoperatively,while the control group employed conventional salt bags for compression.Both groups were follow up and postoperative seroma incidence,visual analogue scale(VAS)scores,evaluation of quality of life using Carolina Comfort Scale(CCS),and satisfaction with HWD usage were analyzed.Results There were no significant differences in preoperative demographic data such as age,sex,and type of hernia between the two groups(P>0.05).A total of 122 patients completed one-week follow-up after surgery,with a follow-up rate of 97.6%.The experimental group exhibited an 8.3%(5/60)seroma incidence compared to a 21.0%(13/62)incidence in the control group,with statistical significance.No significant difference was observed in seroma incidence between the two groups at one month and three months postoperatively.As time progressed after surgery,VAS scores gradually decreased in both groups;however,at 2 hours postoperatively,the experimental group had lower VAS scores than those in the control group(P<0.05).No difference was found in VAS scores of the first week after surgery(P>0.05).The CCS scores of all patients were at a low level one week after surgery,and the experimental group was lower than that of the control group(P<0.05).The patient satisfaction using HWD was 91.6%(55/60).Conclusion Compared with the traditional salt bag compression method,the use of the new HWD after tension-free inguinal hernia day surgery can better reduce the incidence of seroma,relieve postoperative pain,improve the quality of life,with high patient satisfaction.