自固定补片与聚丙烯补片在腹腔镜经腹腹膜前疝修补术中的应用效果比较

doi:10.3877/cma.j.issn.1674-392X.2022.01.014

中华疝和腹壁外科杂志(电子版) ›› 2022, Vol. 16 ›› Issue (01) : 62 -65. doi: 10.3877/cma.j.issn.1674-392X.2022.01.014

临床论著

自固定补片与聚丙烯补片在腹腔镜经腹腹膜前疝修补术中的应用效果比较

肖旺¹, 刘路遥², 汪明明³, 刘丽华⁴^,^†(

)

^1. 410013　长沙，湖南师范大学医学院护理系；410011　长沙，中南大学湘雅二医院普外科
^2. 410000　长沙，湖南省人民医院普外科
^3. 410011　长沙，中南大学湘雅二医院普外科
^4. 410013　长沙，湖南师范大学医学院护理系

收稿日期:2020-12-28 出版日期:2022-02-18
通信作者: 刘丽华
基金资助:
湖南省研究生科研创新项目(CX2018B306)

Application effect analysis of self-fixation mesh and polypropylene mesh in laparoscopic transabdominal preperitioneal laparoscopie herniorrhaphy

Wang Xiao¹, Luyao Liu², Mingming Wang³, Lihua Liu⁴^,^†()

^1. Department of Nursing, College of Medicine, Hunan Normal University, Changsha 410013, China; Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha 410011, China
^2. Department of General Surgery, Hunan Provincial People's Hospital, Changsha 410000, China
^3. Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha 410011, China
^4. Department of Nursing, College of Medicine, Hunan Normal University, Changsha 410013, China

Received:2020-12-28 Published:2022-02-18
Corresponding author: Lihua Liu

全文 ( ) 下载PDF ( ) 导出引用

引用本文：

肖旺, 刘路遥, 汪明明, 刘丽华. 自固定补片与聚丙烯补片在腹腔镜经腹腹膜前疝修补术中的应用效果比较[J/OL]. 中华疝和腹壁外科杂志(电子版), 2022, 16(01): 62-65.

Wang Xiao, Luyao Liu, Mingming Wang, Lihua Liu. Application effect analysis of self-fixation mesh and polypropylene mesh in laparoscopic transabdominal preperitioneal laparoscopie herniorrhaphy[J/OL]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2022, 16(01): 62-65.

目的

比较自固定补片与聚丙烯补片在腹腔镜经腹腹膜前疝修补术（TAPP）中的应用效果。

方法

收集2016年2月至2020年2月于中南大学湘雅二医院治疗腹股沟疝的164例患者的临床资料。按照TAPP术中使用补片不同分为试验组和对照组，各82例。试验组术中应用自固定补片，对照组术中应用聚丙烯补片，2组均平均随访1年。比较2组手术临床指标及术后并发症的发生率。

结果

试验组补片放置时间明显长于对照组（P<0.05），且试验组手术时间明显长于对照组（P<0.05），试验组花费高于对照组（P<0.05）。2组患者的术后的住院时间、术中并发症的发生率差异无统计学意义（P>0.05）。2组术后1 d至3个月视觉模拟评分量表（VAS）的评分均呈下降趋势，差异有统计学意义（P<0.05），且术后各个随访时间点试验组VAS评分低于对照组，差异有统计学意义（P<0.05）。试验组总并发症的发生率（24.39%）低于对照组（32.93%），异物感（1.22%）低于对照组（4.88%），差异均无统计学意义；2组在随访期内均未的复发。

结论

TAPP术中应用自固定补片较聚丙烯补片增加了患者的经济费用，但利于其术后恢复，疼痛较轻，且未增加术后复发的风险。

关键词: 疝，腹股沟, 自固定补片, 聚丙烯补片, 腹腔镜, 疼痛

Objective

To compare the application effect of self-fixation mesh and polypropylene mesh in laparoscopic transabdominal preperitioneal laparoscopie herniorrhaphy (TAPP).

Methods

The clinical data of 164 patients with inguinal hernia admitted to our hospital from Febuary 2016 to Febuary 2020 were retrospectively analyzed, and they were divided into the experiment group and the control group according to different intraoperative mesh, with 82 cases in each group. The 2 group all underwent TAPP operation, the experiment group used self-fixation mesh in the operation, and the control group used polypropylene mesh in the operation, both groups were followed up for an average of one year. The clinical indicators and the incidence of postoperative complications of the two groups were compared between the two groups.

Results

In terms of surgical indicators, the patch placement time of the experimental group was significantly longer than that of the control group (P<0.05), and the operation time of the experimental group was significantly longer than that of the control group (P<0.05), and the cost of the experimental group was significantly higher than that of the control group (P<0.05). There was no statistical significance in the postoperative hospital stay and incidence of intraoperative complications between the two groups (P>0.05). The VAS scores of the two groups showed a downward trend from 1 day to 3 months after operation (P<0.05), and the experiment group was significantly lower than the control group at each time point after operation (P<0.05). The incidence of total complications in the experimental group was not significantly different from that in the control group (24.39% vs 32.93%), but the incidence of foreign body sensation in the experimental group was significantly lower than that in the control group (1.22% vs 4.88%). No recurrence occurred in the two groups during the follow-up period.

Conclusion

Compared with polypropylene mesh, the application of TAPP intraoperative self-fixation mesh increases the cost of patients, but is beneficial to the postoperative recovery of patients with inguinal hernia, with less pain and no increased risk of postoperative recurrence.

Key words: Hernia, inguinal, Self-fixation mesh, Polypropylene mesh, Laparoscopic, Pain

表1 2组患者临床指标比较

组别	例数	手术时间(min,±s)	术后住院时间(d,±s)	铺片耗时(min,±s)	血管损伤[例(%)]	输精管损伤[例(%)]	膀胱损伤[例(%)]	住院花费(元,±s)
试验组	82	72.78±18.26	3.21±1.04	24.75±3.82	3(3.66)	0(0)	0(0)	11 924.85±1377.22
对照组	82	58.43±19.37	3.15±0.98	7.68±4.56	2(2.44)	0(0)	0(0)	6733.29±899.71
t/χ²值		1.180	0.238	2.786	3.765			-1.732
P值		>0.05	>0.05	<0.05	>0.05			<0.05

表1 2组患者临床指标比较

组别	例数	手术时间(min,±s)	术后住院时间(d,±s)	铺片耗时(min,±s)	血管损伤[例(%)]	输精管损伤[例(%)]	膀胱损伤[例(%)]	住院花费(元,±s)
试验组	82	72.78±18.26	3.21±1.04	24.75±3.82	3(3.66)	0(0)	0(0)	11 924.85±1377.22
对照组	82	58.43±19.37	3.15±0.98	7.68±4.56	2(2.44)	0(0)	0(0)	6733.29±899.71
t/χ²值		1.180	0.238	2.786	3.765			-1.732
P值		>0.05	>0.05	<0.05	>0.05			<0.05

表2 2组术后疼痛视觉模拟量表评分比较（分，±s）

组别	例数	术后1 d	术后7 d	术后1个月	术后3个月	F值	P值
试验组	82	2.37±0.95	1.59±0.67	0.73±0.41	0.28±0.24	69.828	<0.05
对照组	82	3.26±1.07	2.64±0.59	1.58±0.46	0.63±0.35	95.732	<0.05
t值		3.519	6.653	7.803	4.665
P值		<0.05	<0.05	<0.05	<0.05

表2 2组术后疼痛视觉模拟量表评分比较（分，±s）

组别	例数	术后1 d	术后7 d	术后1个月	术后3个月	F值	P值
试验组	82	2.37±0.95	1.59±0.67	0.73±0.41	0.28±0.24	69.828	<0.05
对照组	82	3.26±1.07	2.64±0.59	1.58±0.46	0.63±0.35	95.732	<0.05
t值		3.519	6.653	7.803	4.665
P值		<0.05	<0.05	<0.05	<0.05

[1]	王帆，靳翠红，赵凤林, 等. 自固定补片与钉合固定补片在巨大腹股沟疝行腹腔镜经腹腹膜前疝修补术中的对比研究[J]. 首都医科大学学报, 2017, 38(6): 911-914.
[2]	Sanders DL, Nienhuijs S, Ziprin P, et al. Randomized clinical trial comparing self-gripping mesh with suture fixation of lightweight polypropylene mesh in open inguinal hernia repair[J]. Br J Surg, 2014, 101(11): 1373-1382; discussion 1382.
[3]	孔岩，祝筠，韩芳. 造口旁疝患者行腹腔内网片植入术的围术期护理[J]. 护士进修杂志, 2014, 29(22): 2065-2067.
[4]	吴际，田世堂，梁冰. 腹膜前间隙放置补片修复治疗腹壁切口疝17例疗效观察[J]. 贵州医药, 2014, 38(7): 646-647.
[5]	中华医学会外科学分会疝和腹壁外科学组，中国医师协会外科医师分会疝和腹壁外科医师委员会. 成人腹股沟疝诊疗指南(2018年版)[J]. 中华外科杂志, 2018, 38(7): 704-706.
[6]	Hoyuela C, Juvany M, Carvajal F, et al. Randomized clinical trial of mesh fixation with glue or sutures for Lichtenstein hernia repair[J]. Br J Surg, 2017, 104(6): 688-694.
[7]	Verhagen T, Zwaans WA, Loos MJ, et al. Randomized clinical trial comparing self-gripping mesh with a standard polypropylene mesh for open inguinal hernia repair[J]. Br J Surg, 2016, 103(7): 812-818.
[8]	徐宁. 腹腔镜下完全腹膜外腹股沟疝修补术两种固定补片方式的临床效果比较[J]. 实用临床医药杂志, 2016, 20(24): 86-87.
[9]	刘进军，张鹏，余波, 等. Ⅰ、Ⅱ型腹股沟疝腹腔镜经腹腹膜前疝修补术中不固定补片与缝合固定补片的比较研究[J]. 腹腔镜外科杂志, 2017, 22(5): 368-372.
[10]	郭彪，李向国，胡明高. 自固定补片与普通聚丙烯补片在腹腔镜全腹膜外疝修补术中的对比研究[J]. 腹腔镜外科杂志, 2016, 21(9): 700-704.
[11]	Ladurner R, Drosse I, Chiapponi C, et al. Polypropylene meshes coated with a polysaccharide based bioadhesive for intra-abdominal mesh fixation in a rabbit model[J]. Surg Endosc, 2013, 27(6): 1991-1996.
[12]	Odobasic A, Krdzalic G, Hodzic M, et al. The role of fibrin glue polypropylene mesh fixation in open inguinal hernia repair[J]. Med Arch, 2014, 68(2): 90-93.
[13]	杜一鸿，刘云莉，刘明杰. 自固定补片不同铺置方法在腹腔镜双侧腹股沟疝修补术中的应用[J]. 中国现代手术学杂志, 2017, 21(5): 344-349.
[14]	Peres MA, Aguiar HR, Andreollo NA. Surgical treatment of subcostal incisional hernia with polypropylene mesh-analysis of late results[J]. Rev Col Bras Cir, 2014, 41(2): 82-86.
[15]	Ferrarese A, Bindi M, Rivelli M, et al. Self-gripping mesh versus fibrin glue fixation in laparoscopic inguinal hernia repair: a randomized prospective clinical trial in young and elderly patients[J]. Open Med(Wars), 2016, 11(1): 497-508.
[16]	黄亮，余壮明，李军, 等. 自固定聚丙烯/聚乳酸复合补片改善腹股沟疝无张力修补后的慢性疼痛[J]. 中国组织工程研究, 2018, 22(6): 908-913.
[17]	朱建明，徐一宁，蒋海峰, 等. 自固定补片和传统补片在老年腹股沟斜疝患者手术治疗中的比较[J]. 临床外科杂志, 2016, 24(4): 311-313.

[1]	燕速, 霍博文. 腹腔镜食管胃结合部腺癌根治性切除术[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 13-13.
[2]	母德安, 李凯, 张志远, 张伟. 超微创器械辅助单孔腹腔镜下脾部分切除术[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 14-14.
[3]	李国新, 陈新华. 全腹腔镜下全胃切除术食管空肠吻合的临床研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 1-4.
[4]	李子禹, 卢信星, 李双喜, 陕飞. 食管胃结合部腺癌腹腔镜手术重建方式的选择[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 5-8.
[5]	李乐平, 张荣华, 商亮. 腹腔镜食管胃结合部腺癌根治淋巴结清扫策略[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 9-12.
[6]	陈方鹏, 杨大伟, 金从稳. 腹腔镜近端胃癌切除术联合改良食管胃吻合术重建His角对术后反流性食管炎的效果研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 15-18.
[7]	许杰, 李亚俊, 韩军伟. 两种入路下腹腔镜根治性全胃切除术治疗超重胃癌的效果比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 19-22.
[8]	李刘庆, 陈小翔, 吕成余. 全腹腔镜与腹腔镜辅助远端胃癌根治术治疗进展期胃癌的近中期随访比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 23-26.
[9]	任佳, 马胜辉, 王馨, 石秀霞, 蔡淑云. 腹腔镜全胃切除、间置空肠代胃术的临床观察[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 31-34.
[10]	王庆亮, 党兮, 师凯, 刘波. 腹腔镜联合胆道子镜经胆囊管胆总管探查取石术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 313-313.
[11]	杨建辉, 段文斌, 马忠志, 卿宇豪. 腹腔镜下脾部分切除术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 314-314.
[12]	叶劲松, 刘驳强, 柳胜君, 吴浩然. 腹腔镜肝Ⅶ+Ⅷ段背侧段切除[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 315-315.
[13]	郭兵, 王万里, 何凯, 黄汉生. 腹腔镜下肝门部胆管癌根治术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(01): 143-143.
[14]	李凯, 陈淋, 苏怀东, 向涵, 张伟. 超微创器械在改良单孔腹腔镜巨大肝囊肿开窗引流及胆囊切除中的应用[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(01): 144-144.
[15]	魏丽霞, 张安澜, 周宝勇, 李明. 腹腔镜下Ⅲb型肝门部胆管癌根治术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(01): 145-145.

阅读次数

全文

摘要

选择文件类型/文献管理软件名称

选择包含的内容

Application effect analysis of self-fixation mesh and polypropylene mesh in laparoscopic transabdominal preperitioneal laparoscopie herniorrhaphy

模态框（Modal）标题

选择文件类型/文献管理软件名称

选择包含的内容

Application effect analysis of self-fixation mesh and polypropylene mesh in laparoscopic transabdominal preperitioneal laparoscopie herniorrhaphy