切换至 "中华医学电子期刊资源库"

中华疝和腹壁外科杂志(电子版) ›› 2019, Vol. 13 ›› Issue (04) : 298 -301. doi: 10.3877/cma.j.issn.1674-392X.2019.04.003

所属专题: 文献

论著

标准聚丙烯补片与部分可吸收补片在腹股沟疝腹膜前修补术中的疗效
李金龙1, 田丹2, 刘宇3, 韩刚1,()   
  1. 1. 130041 长春,吉林大学第二医院胃肠营养及疝外科
    2. 130041 长春,吉林大学第二医院麻醉科
    3. 130061 长春,解放军第208医院麻醉科
  • 收稿日期:2019-03-14 出版日期:2019-08-18
  • 通信作者: 韩刚
  • 基金资助:
    吴阶平医学基金会临床科研专项资助基金(320.6750.16012)

Comparative study of standard and partial absorbable polypropylene mesh in preperitoneal hernioplasty

Jinlong Li1, Dan Tian2, Yu Liu3, Gang Han1,()   

  1. 1. Department of Gastrointestinal Surgery, the Second Hospital of Jilin University, Changchun 130041, China
    2. Department of Anesthesia, the Second Hospital of Jilin University, Changchun 130041, China
    3. Department of Anesthesia, Changchun PLA 208 Hospital, Changchun 130061, China
  • Received:2019-03-14 Published:2019-08-18
  • Corresponding author: Gang Han
  • About author:
    Corresponding author: Han Gang, Email:
引用本文:

李金龙, 田丹, 刘宇, 韩刚. 标准聚丙烯补片与部分可吸收补片在腹股沟疝腹膜前修补术中的疗效[J/OL]. 中华疝和腹壁外科杂志(电子版), 2019, 13(04): 298-301.

Jinlong Li, Dan Tian, Yu Liu, Gang Han. Comparative study of standard and partial absorbable polypropylene mesh in preperitoneal hernioplasty[J/OL]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2019, 13(04): 298-301.

目的

比较标准聚丙烯补片与部分可吸收补片在腹股沟疝腹膜前修补中的差异。

方法

采用前瞻性随机对照的研究方法,对2018年1至9月吉林大学第二医院148例单侧男性腹股沟疝患者随机分为标准聚丙烯补片组(PM组,73例)和部分可吸收补片组(PAM组,75例),分别应用标准聚丙烯补片和部分可吸收补片进行腹膜前腹股沟疝修补术。术后分别观察2组的术后平均住院时间、血清肿、补片感染、术后疼痛、复发、异物感以及治疗费用等相关情况,并应用生活质量评价量表(SF-36)评估其生活质量。

结果

2组患者术后平均住院时间、血清肿发生率、补片感染率、复发率均比较,差异均无统计学意义(P>0.05);术后6个月疼痛感、局部异物感和治疗费用比较,差异均有统计学意义(P<0.001、0.016 8、<0.001);2组患者术后SF-36评分比较,差异无统计学意义(P>0.05)。

结论

应用部分可吸收补片可改善患者术后疼痛和异物感的情况,但是需要较高的治疗费用;标准聚丙烯补片与部分可吸收补片均不影响患者术后的生活质量。

Objective

To compare the difference in postoperative effects between standard polypropylene (SP) mesh and partial absorbable (PA) mesh in preperitoneal hernioplasty.

Methods

A prospective randomized controlled study was conducted to investigate 148 male patients with unilateral inguinal hernia in the Second Hospital of Jilin University between January 2018 and September 2018. They were randomly divided into two groups: SP mesh group (73 patients) and the PA mesh group (75 patients). A tension-free repair using the preperitoneal hernioplasty technique was performed on all patients. The postoperative hospital stay, seroma, mesh infection, postoperative pain, recurrence, foreign body sensation and hospital cost were compared between the two groups, as well as the patients' quality of life was evaluated by the Medical Outcomes Study Short-Form (SF) 36 questionnaire which was completed by the patient.

Results

No statistical difference was observed for average length of stay, incidence of seroma, mesh infection rate and recurrence rate between the two groups (P>0.05). There were significant differences in pain at 6 months after operation (P<0.001), foreign body sensation (P=0.016 8) and hospital cost (P<0.001) between the two groups. No statistical difference was observed for SF-36 score between the two groups (P>0.05).

Conclusion

Implantation of partial absorbable mesh can ameliorate postoperative pain and foreign sensation but will need more curative cost for patients. Neither of the mesh would affect the quality of patients' life after operation.

表1 2组男性单侧腹股沟疝患者术前和术中的一般情况比较
表2 2组男性单侧腹股沟疝患者术后相关指标比较
表3 2组男性单侧腹股沟疝患者生活质量评价量表比较(分,±s
[1]
Simons MP, Aufenacker T, Bay-Nielsen M, et al. European Hernia Society guidelines on the treatment of inguinal hernia in adult patients[J]. Hernia, 2009, 13(4): 343-403.
[2]
Akolekar D, Kumar S, Khan LR, et al. Comparison of recurrence with lightweight composite polypropylene mesh and heavyweight mesh in laparoscopic totally extraperitoneal inguinal hernia repair: an audit of 1, 232 repairs[J]. Hernia, 2008, 12(1): 39-43.
[3]
Achelrod D, Stargardt T. Cost-utility analysis comparing heavy-weight and light-weight mesh in laparoscopic surgery for unilateral inguinal hernias[J]. Appl Health Econ Health Policy, 2014, 12(2): 151-163.
[4]
Lionetti R, Neola B, Dilillo S, et al. Sutureless hernioplasty with light-weight mesh and fibrin glue versus Lichtenstein procedure: a comparison of outcomes focusing on chronic postoperative pain[J]. Hernia, 2012, 16(2): 127-131.
[5]
陈杰. 实用疝外科手术技巧[M]. 北京: 北京科学技术出版社, 2008: 64.
[6]
Klinge U, Klosterhalfen B, Müller M, et al. Foreign body reaction to meshes used for the repair of abdominal wall hernias[J]. Eur J Surg, 1999, 165(7): 665-673.
[7]
Yang H, Liu Y, Chen J, et al. The management of mesh infection after laparoscopic inguinal hernia repair[J]. Surg Laparosc Endosc Percutan Tech, 2019, 29(1): 40-42.
[8]
Koyama M, Miyagawa Y, Yamamoto Y, et al. Surgery for chronic mesh infection occurred 10 years after sacrectomy - Mesh resection and mesentric leaf repair: A case report[J]. Int J Surg Case Rep, 2017, 30: 215-217.
[9]
Nikkolo C, Lepner U, Murruste M, et al. Randomised clinical trial comparing lightweight mesh with heavyweight mesh for inguinal hernioplasty[J]. Hernia, 2010, 14(3): 253-258.
[10]
Rutegård M, Gümüsçü R, Stylianidis G, et al. Chronic pain, discomfort, quality of life and impact on sex life after open inguinal hernia mesh repair: an expertise-based randomized clinical trial comparing lightweight and heavyweight mesh[J]. Hernia, 2018, 22(3): 411-418.
[11]
Śmietański M, Śmietańska IA, Modrzejewski A, et al. Systematic review and meta-analysis on heavy and lightweight polypropylene mesh in Lichtenstein inguinal hernioplasty[J]. Hernia, 2012, 16(5): 519-528.
[12]
Smietański M, Bury K, Smietańska IA, et al. Five-year results of a randomised controlled multi-centre study comparing heavy-weight knitted versus low-weight, non-woven polypropylene implants in Lichtenstein hernioplasty[J]. Hernia, 2011, 15(5): 495-501.
[13]
Wang D, Chen J, Chen Y, et al. Prospective Analysis of Epigastric, Umbilical, and Small Incisional Hernia Repair Using the Modified Kugel Oval Patch[J]. Am Surg, 2018, 84(2): 305-308.
[14]
Okinaga K, Hori T, Inaba T, et al. A randomized clinical study on postoperative pain comparing the Polysoft patch to the modified Kugel patch for transinguinal preperitoneal inguinal hernia repair[J]. Surg Today, 2016, 46(6): 691-698.
[15]
Classification of chronic pain. Descriptions of chronic pain syndromes and definitions of pain terms. Prepared by the International Association for the Study of Pain, Subcommittee on Taxonomy[J]. Pain Suppl, 1986, 3: S1-S226.
[1] 刘柏隆, 周祥福. 经阴道膀胱膨出前盆补片修补术 + 阴道后壁修补术[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2025, 19(01): 128-128.
[2] 曹能琦, 张恒, 郑立锋, 陶庆松, 嵇振岭. Ad-Hoc 自裁剪补片用于造口旁疝Sugarbaker 修补术[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 620-623.
[3] 皮尔地瓦斯·麦麦提玉素甫, 李慧灵, 艾克拜尔·艾力, 李赞林, 王志, 克力木·阿不都热依木. 生物补片修补巨大复发性腹壁切口疝临床疗效分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 624-628.
[4] 马东扬, 李斌, 陆安清, 王光华, 雷文章, 宋应寒. Gilbert 与单层补片腹膜前疝修补术疗效的随机对照研究[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 629-633.
[5] 王浩源, 汪海洋, 孙建明, 陈以宽, 祁小桐, 唐博. 腹腔镜与开放修补对肝硬化腹外疝患者肝功能及凝血的影响[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 654-659.
[6] 周正阳, 陈凯, 仇多良, 邵乐宁, 吴浩荣, 钟丰云. 腹腔镜腹股沟疝修补术后出血原因分析及处理[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 660-664.
[7] 顾熙, 徐子宇, 周澍, 张吴楼, 张业鹏, 林昊, 刘宗航, 嵇振岭, 郑立锋. 腹股沟疝腹膜前间隙无张力修补术后补片感染10 例报道[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 665-669.
[8] 宋俊锋, 张珍珍. 单侧初发性腹股沟斜疝老年患者经腹腹膜前疝修补术中残余疝囊腹直肌下缘固定效果评估[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 670-674.
[9] 高娟, 徐建庆, 闫芳, 丁盛华, 刘霞. Rutkow、TAPP、TEP 手术治疗单侧腹股沟疝患者的临床疗效及对血清炎症因子水平的影响[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 675-680.
[10] 于新峰, 曾琦, 后强, 徐浩, 操谢芳. 腹腔镜经腹腹膜前疝修补术和腹腔镜完全腹膜外疝修补术对成人腹股沟疝治疗效果及预后分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 681-686.
[11] 臧宇, 姚胜, 朱新勇, 戎世捧, 田智超. 低温等离子射频消融治疗腹壁疝术后补片感染的临床效果[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 687-692.
[12] 方辉强, 黄杰, 随冰琰. 腰方肌阻滞与腹横肌平面阻滞对腹股沟疝腹腔镜手术患者术后镇痛效果的影响[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 697-702.
[13] 朱佳琳, 方向, 贵诗雨, 黄丹, 周小雨, 郭文恺. 大鼠切口疝腹膜前间隙补片修补术后血清中VEGF 和Ang-1 的表达情况[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 703-707.
[14] 张晋伟, 董永红, 王家璇. 基于GBD2021 数据库对中国与全球老年人疝疾病负担和健康不平等的分析比较[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 708-716.
[15] 杨媛媛, 林贤超, 林荣贵, 陆逢春, 黄鹤光. 肌后/腹膜前补片修补巨大切口疝术后并发症防治[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 645-648.
阅读次数
全文


摘要