切换至 "中华医学电子期刊资源库"
高级检索
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) ›› 2022, Vol. 16 ›› Issue (05) : 535 -539. doi: 10.3877/cma.j.issn.1674-392X.2022.05.010

临床论著

国产生物补片与聚丙烯补片在日间腹股沟斜疝Lichtenstein修补术中的疗效对比
徐睿1,†(), 彭露1, 周俊杰1, 钱群1   
  1. 1. 430071　武汉大学中南医院疝病诊疗中心
  • 收稿日期:2022-06-09 出版日期:2022-10-18
  • 通信作者: 徐睿
  • 基金资助:
    吴阶平医学基金会临床科研专项资助基金(320.6750.19091-11)

Comparison of the efficacy of domestic biological mesh and polypropylene mesh in daytime Lichtenstein repair of oblique inguinal hernia

Rui Xu1,†(), Lu Peng1, Junjie Zhou1, Qun Qian1   

  1. 1. Department of General Surgery, Clinical Center of Hernia, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China
  • Received:2022-06-09 Published:2022-10-18
  • Corresponding author: Rui Xu
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

徐睿, 彭露, 周俊杰, 钱群. 国产生物补片与聚丙烯补片在日间腹股沟斜疝Lichtenstein修补术中的疗效对比[J]. 中华疝和腹壁外科杂志(电子版), 2022, 16(05): 535-539.

Rui Xu, Lu Peng, Junjie Zhou, Qun Qian. Comparison of the efficacy of domestic biological mesh and polypropylene mesh in daytime Lichtenstein repair of oblique inguinal hernia[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2022, 16(05): 535-539.

目的

探讨猪小肠黏膜下层生物补片在腹股沟疝日间手术中的应用价值。

方法

回顾分析2019年1月至2020年12月武汉大学中南医院疝病诊疗中心100例接受日间Lichtenstein手术的腹股沟疝患者。根据使用补片的不同分为试验组（SIS补片）和对照组（聚丙烯补片），记录2组患者的临床参数和术后并发症发生情况，对比数据进行统计学分析。

结果

2组手术时间，差异无统计学意义（P>0.05）。术后1周，试验组患者术后发热、切口血清肿多于对照组（P<0.05）；而试验组术后切口感染和疼痛发生率均低于对照组（P<0.05）。术后1年，试验组慢性疼痛、异物感发生率均低于对照组（P<0.05）；2组复发率比较，差异无统计学意义（P>0.05）。

结论

在开放腹股沟疝手术中，SIS补片术后早期发热及血清肿发生率高于聚丙烯补片，但在早期切口感染及疼痛方面优于聚丙烯补片；在远期慢性疼痛和异物感方面，SIS补片也优于聚丙烯补片，临床应用应遵循个体化原则。

关键词: 疝，腹股沟, 生物补片, 疝修补术, 日间手术, 疗效
Objective

To investigate the application value of porcine small intestinal submucosa biological mesh in day surgery for inguinal hernia.

Methods

The retrospective study enrolled a total of 100 patients with inguinal hernia who underwent Lichtenstein surgery in the ambulatory ward of Zhongnan Hospital of Wuhan University from January 2019 to December 2020. Patients were divided into two groups: the small intestine submucosa mesh (SIS) group and the polypropylene mesh (Control) group. Clinical demographic data, intraoperative data and postoperative complications were collected and analyzed.

Results

In terms of operative time, there was no statistical significance (P>0.05) between the SIS group and the control group. Analysis of early postoperative outcomes revealed that the number of patients with postoperative fever and seroma significantly increased in the SIS group (P<0.05); the number of patients with postoperative incision infection and postoperative pain significantly decreased in the SIS group (P<0.05). Long-term postoperative outcomes results suggested that the SIS group could significantly improve chronic pain and foreign body sensation compared to the control group (P<0.05). No statistical difference of recurrence rate was found between the SIS group and the control group at 1 year after surgery (P>0.05).

Conclusion

The incidence of early postoperative fever and seroma is higher with SIS mesh than with polypropylene mesh, but SIS mesh is superior to polypropylene mesh in terms of early incisional infection and pain. SIS mesh is also superior to polypropylene mesh in terms of distant chronic pain and foreign body sensation, and individualized principles should be followed by clinical application.

Key words: Hernia, inguinal, Biological mesh, Herniorrhaphy, Day surgery, Efficacy
表1 2组患者一般资料比较（±s）
组别 例数 年龄(岁) 体质量指数(kg/m2) 手术时间(min)
试验组 50 57.2±13.6 24.6±3.2 52.7±14.5
对照组 50 61.3±14.2 23.5±3.7 45.6±11.3
t值   1.290 0.682 1.481
P值   0.213 0.478 0.149
表2 2组患者术后1周不良反应比较[例（%）]
组别 例数 术后发热 切口感染 术后VAS评分(±s) 术后血清肿
试验组 50 9 (18.0) 0 3±1 17(34.0)
对照组 50 1 (2.0) 4(8.0) 5±2 3(6.0)
χ2/t   7.111 4.167 2.893 12.250
P值   0.008 0.041 0.005 0.000
表3 2组术后1年不良反应比较[例（%）]
组别 例数 慢性疼痛 异物感 补片感染 复发
试验组 50 0 2(4) 0 0
对照组 50 4 (8) 11(22) 1 (2) 0
χ2   4.167 7.162 1.010 -
P值   0.041 0.007 0.315 -
[1]
唐健雄，华蕾，张逖. 上海成人腹股沟疝患病情况的多中心研究[J]. 外科理论与实践, 2002, 7(6): 421-422.
[2]
孙立，陈杰，申英末. 国产新型生物疝修补片与聚丙烯产品在腹股沟疝修补术中的疗效对比[J/OL]. 中华疝和腹壁外科杂志(电子版), 2019, 13(2): 101-104.
[3]
成人腹股沟疝诊断和治疗指南(2018年版)[J/OL]. 中华疝和腹壁外科杂志(电子版), 2018, 12(4): 244-246.
[4]
王伟刚，俞永江. 疝补片材料学的现状和展望[J]. 中国普外基础与临床杂志, 2022, 29(4): 556-560.
[5]
Huerta S, Varshney A, Patel P M, et al. Biological mesh implants for abdominal hernia repair: US food and drug administration approval process and systematic review of its efficacy[J]. JAMA Surg, 2016, 151(4): 374-381.
[6]
靳翠红，申英末，孙立, 等. 国产新型生物补片的安全性及有效性研究[J/OL]. 中华疝和腹壁外科杂志(电子版), 2019, 13(1): 16-20.
[7]
任利东，曹中伟，娜日娜, 等. 国产猪小肠黏膜下层生物补片与聚丙烯补片在Lichtenstein疝修补术中的应用[J/OL]. 中华疝和腹壁外科杂志(电子版), 2019, 13(6): 585-588.
[8]
李宝山，代金明，满艺, 等. 猪小肠黏膜下层生物补片应用于腹股沟疝修补术的远期疗效[J]. 中华消化外科杂志, 2021, 20(7): 810-814.
[9]
嵇武，刘亚萍，戴玮. 我国日间手术开展现状与前景展望[J]. 中国实用外科杂志, 2020, 40(2): 199-202.
[10]
申英末，孙立，陈杰. 腹股沟疝日间手术的发展历程及诊疗经验[J]. 中华消化外科杂志, 2020, 19(7): 725-728.
[11]
安燚，王振军. 日间手术的概念和基本问题[J]. 中国实用外科杂志, 2007(1): 38-40.
[12]
陈松耀，戴伟钢，陈创奇. 生物补片在疝与腹壁外科的临床应用进展[J/OL]. 中华疝和腹壁外科杂志(电子版), 2018, 12(2): 90-93.
[13]
Reid F M, Elders A, Breeman S, et al. How common are complications following polypropylene mesh, biological xenograft and native tissue surgery for pelvic organ prolapse? A secondary analysis from the PROSPECT trial[J]. BJOG, 2021, 128(13): 2180-2189.
[14]
Nie X, Xiao D, Wang W, et al. Comparison of Porcine Small Intestinal Submucosa versus Polypropylene in Open Inguinal Hernia Repair: A Systematic Review and Meta-Analysis[J]. PLoS One, 2015, 10(8), e0135073.
[15]
Ansaloni L, Catena F, D'Alessandro L. Prospective randomized, double-blind, controlled trial comparing Lichtenstein's repair of inguinal hernia with polypropylene mesh versus Surgisis gold soft tissue graft: preliminary results[J]. Acta Biomed, 2003, 74 Suppl 2: 10-14.
[16]
Li B, Zhang X, Man Y, et al. Lichtenstein inguinal hernia repairs with porcine small intestine submucosa: a 5- year follow-up. a prospective randomized controlled study[J]. Regen Biomater, 2021, 8(1): rbaa055.
[17]
孙立，陈杰，申英末, 等. 生物补片在腹股沟疝治疗中应用[J]. 中国实用外科杂志, 2017, 11(11): 1223-1227.
[18]
申英末，陈杰，杨硕, 等. 脱细胞基质材料生物补片在青少年（6~18岁）患者腹股沟疝修补术中应用的研究[J/OL]. 中华疝和腹壁外科杂志(电子版), 2011, 5(1): 71-76.
[19]
戴维，彭文定，陈念平, 等. 组织胶水在腹股沟疝无张力修补术切口的应用研究[J]. 吉林医学, 2015, 36(18): 4008-4009.
[20]
Miserez M, Lefering R, Famiglietti F, et al. Synthetic Versus Biological Mesh in Laparoscopic and Open Ventral Hernia Repair(LAPSIS): Results of a Multinational, Randomized, Controlled, and Double-blind Trial[J]. Ann Surg, 2021, 273(1): 57-65.
[21]
Zhou H, Shen Y, Zhang Z, et al. Comparison of outcomes of ventral hernia repair using different meshes: a systematic review and network meta-analysis[J]. Hernia, 2022, Online ahead of print.
[22]
Sweitzer K, Carruthers K H, Blume L, et al. The Biomechanical Properties of Meshed versus Perforated Acellular Dermal Matrices(ADMs)[J]. Plast Reconstr Surg Glob Open, 2021, 9(3): e3454.
[23]
Liu Y, Cao Z, Yang H, et al. Porcine Small Intestinal Submucosa Mesh to Treat Inguinal Hernia in Young Adults Using Laparoscopic Inguinal Hernia Repair: A Retrospective Controlled Study[J]. Surg Laparosc Endosc Percutan Tech, 2020, 30(4): 367-370.
[24]
Ravo B, Falasco G. Pure tissue inguinal hernia repair with the use of biological mesh: a 10-year follows up. A prospective study[J]. Hernia, 2020, 24(1): 121-126.
[25]
Novitsky Y W, Rosen M J. The biology of biologics: basic science and clinical concepts[J]. Plast Reconstr Surg, 2012, 130(5 Suppl 2): 9S-17S.
[26]
Ansaloni L, Catena F, Coccolini F, et al. Inguinal hernia repair with porcine small intestine submucosa: 3-year follow-up results of a randomized controlled trial of Lichtenstein's repair with polypropylenemesh versus Surgisis Inguinal Hernia Matrix[J]. Am J Surg, 2009, 198( 3): 303-312.
[27]
陈俊生，宋晓彪，郭剑辉, 等. 脱细胞基质材料在腹腔镜治疗青年腹股沟疝临床效果[J/OL]. 中华疝和腹壁外科杂志(电子版), 2021, 15(3): 288-292.
[28]
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.
[29]
Pande T, Naidu C S. Mesh infection in cases of polypropylene mesh hernioplasty[J]. Hernia J Hernias Abdom Wall Surg, 2020, 24(4): 849-856.
[30]
Mestak O, Matouskova E, Spurkova Z, et al. Mesenchymal stem cells seeded on cross-linked and noncross-linked acellular porcine dermal scaffolds for long-term full-thickness hernia repair in a small animal model[J]. Artif Organs, 2014, 38(7): 572-579.
[1] 曹迪, 张玉茹. 经腹腔镜生物补片修补直肠癌根治术后盆底疝1例[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 115-116.
[2] 田文, 杨晓冬. 腹腔镜腹股沟疝修补术式选择及注意事项[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 595-597.
[3] 李涛, 陈纲, 李世拥. 腹腔镜下右侧腹股沟斜疝修补术（TAPP）[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 598-598.
[4] 陈航, 闵翔. 日间甲状腺切除术后出血的12例临床分析及应对措施[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 600-602.
[5] 叶晋生, 路夷平, 梁燕凯, 于淼, 冀祯, 贺志坚, 张洪海, 王洁. 腹腔镜下应用生物补片修补直肠术后盆底缺损的疗效[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 688-691.
[6] 王可, 范彬, 李多富, 刘奎. 两种疝囊残端处理方法在经腹腹膜前腹股沟疝修补术中的疗效比较[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 692-696.
[7] 袁伟, 张修稳, 潘宏波, 章军, 王虎, 黄敏. 平片式与填充式腹股沟疝修补术的疗效比较[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 697-701.
[8] 夏松, 姚嗣会, 汪勇刚. 经腹腹膜前与疝环充填式疝修补术治疗腹股沟疝的对照研究[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 702-705.
[9] 刘跃刚, 薛振峰. 腹腔镜腹股沟疝日间手术在老年患者中的安全性分析[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 711-714.
[10] 杨瑞洲, 李国栋, 吴向阳. 腹股沟疝术后感染的治疗方法探讨[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 715-719.
[11] 徐金林, 陈征. 抗菌药物临床应用监测对腹股沟疝修补术预防用药及感染的影响[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 720-723.
[12] 于智慧, 赵建军. 后路腰方肌阻滞复合全身麻醉在腹股沟斜疝经腹腹膜前手术中的应用效果[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 734-739.
[13] 田静, 方秀春. 超声引导下横筋膜平面阻滞在儿童腹股沟疝手术的应用效果[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 740-744.
[14] 李静如, 王江玲, 吴向阳. 简易负压引流在腹股沟疝术后浅部感染中的疗效分析[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 745-749.
[15] 王红艳, 马艳丽, 郑洁灿. 手术室综合护理在腹股沟疝手术中的应用效果[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 755-758.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号