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中华疝和腹壁外科杂志(电子版)

中华疝和腹壁外科杂志(电子版) ›› 2021, Vol. 15 ›› Issue (04) : 375 -378. doi: 10.3877/cma.j.issn.1674-392X.2021.04.015

临床论著

ProGripTM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
康欣1,†(), 杨显富1, 杨兴建1, 尹天圣1, 张雅军1, 李斌1, 徐茂林1, 杨小丽1, 徐玲2   
  1. 1. 610000　四川省成都市双流区第一人民医院普外科
    2. 610000　四川省成都市双流区第一人民医院科教科
  • 收稿日期:2019-11-04 出版日期:2021-08-18
  • 通信作者: 康欣

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

Xin Kang1,†(), Xianfu Yang1, Xingjian Yang1, Tiansheng Yin1, Yajun Zhang1, Bin Li1, Maolin Xu1, Xiaoli Yang1, Ling Xu2   

  1. 1. Department of General Surgery, Shuangliu District First People's Hospital, Chengdu 610000, China
    2. Department of Science and Education, Shuangliu District First People's Hospital, Chengdu 610000, China
  • Received:2019-11-04 Published:2021-08-18
  • Corresponding author: Xin Kang
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引用本文：

康欣, 杨显富, 杨兴建, 尹天圣, 张雅军, 李斌, 徐茂林, 杨小丽, 徐玲. ProGripTM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[J]. 中华疝和腹壁外科杂志(电子版), 2021, 15(04): 375-378.

Xin Kang, Xianfu Yang, Xingjian Yang, Tiansheng Yin, Yajun Zhang, Bin Li, Maolin Xu, Xiaoli Yang, Ling Xu. Randomized controlled trial comparing self-gripping mesh (ProgripTM) and ULTRAPRO Hernia System (UHS) in tension-free repair of inguinal hernia[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2021, 15(04): 375-378.

目的

比较ProGripTM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ProGripTM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）；ProGripTM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）。ProGripTM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ProGripTM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。

关键词: 疝，腹股沟, 疝修补术, 慢性疼痛, 自固定补片
Objective

To compare the differences between ProGripTM 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 ProGripTM 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 ProGripTM self-gripping mesh group and the UHS repair group (P<0.05). The average operation time and hospital stay in the ProGripTM 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 ProGripTM self-gripping mesh group; in the ProGripTM 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 ProGripTM self-gripping mesh in the treatment of patients with inguinal hernia. It is worth the clinical promotion.

Key words: Hernia, inguinal, Herniorrhaphy, Chronic pain, Self-gripping (Progrip?) mesh
表1 2组患者一般资料比较
组别 例数 年龄 性别 合并症[例(%)] 吸烟[例(%)] 疝分型[例(%)]
男性 女性 COPD 前列腺增生 糖尿病 Ⅰ Ⅱ Ⅲ
UHS补片组 150 58.2±15.9 120 30 11(7.3) 7(4.7) 8(5.3) 19(12.7) 35(23.3) 85(56.7) 30(20.0)
ProGripTM自固定补片组 150 56.3±13.8 125 25 15(10.0) 9(6.0) 10(6.7) 17(11.3) 38(25.3) 83(55.3) 29(19.3)
P值   0.270 0.551 0.248 0.713 0.519
组别 例数 疝分类[例(%)] 麻醉[例(%)]
斜疝 直疝 复合疝 局麻 腰麻/腰硬联合 全麻
UHS补片组 150 85(56.7) 50(33.3) 5(3.3) 17(11.3) 131(87.3) 2(1.3)
ProGripTM自固定补片组 150 90(60.0) 41(27.3) 9(6.0) 19(12.7) 138(92.0) 3(2.0)
P值   0.519 0.873
表2 2组患者手术情况及术后并发症发生情况比较
组别 例数 住院费用(元,±s) 慢性疼痛[例(%)] 切口感染[例(%)] 切口血肿[例(%)] 异物感 阴囊积液[例(%)] 复发[例(%)] 手术时间(min,±s)
UHS补片组 150 8870±1456 27(18.0) 2(1.3) 3(2.0) 12(8.0) 7(4.7) 1(0.7) 59.16±17.05
ProGripTM自固定补片组 150 8710±1345 8(5.3) 0 0 2(1.3) 1(0.7) 1(0.7) 46.27±16.17
统计值   -0.989 11.677 / / 7.493 4.623 0.0 22.23
P值   0.323 0.001     0.006 0.067 1.0 <0.001
表3 2组患者术后VAS的比较
组别 例数 术后1 d 术后1周 术后1个月 术后3个月 术后6个月
UHS补片组 150 4.12±1.52 2.51±1.46 0.94±1.39 0.85±1.43 0.87±1.81
ProGripTM自固定补片组 150 3.85±1.48 2.31±1.22 0.46±0.88 0.42±0.93 0.20±0.89
t值   1.055 1.287 2.753 2.332 3.104
P值   0.120 0.199 0.070 0.021 0.020
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