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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) ›› 2022, Vol. 16 ›› Issue (05) : 540 -543. doi: 10.3877/cma.j.issn.1674-392X.2022.05.011

临床论著

生物补片与自固定补片在腹股沟疝修补术中的临床对照研究
董国强1, 元海成1, 张兴洲1, 张楠1,†()   
  1. 1. 300110　天津市南开医院胃肠疝外科
  • 收稿日期:2022-06-09 出版日期:2022-10-18
  • 通信作者: 张楠
  • 基金资助:
    吴阶平医学基金会卓越外科专项基金资助项目(320.6750.19093-2)

Clinical comparative study of biological mesh and self-gripping mesh in inguinal hernia repair

Guoqiang Dong1, Haicheng Yuan1, Xingzhou Zhang1, Nan Zhang1,†()   

  1. 1. Department of Gastrointestinal and Hernia Surgery, Tianjin Nankai Hospital, Tianjin 300110, China
  • Received:2022-06-09 Published:2022-10-18
  • Corresponding author: Nan Zhang
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引用本文：

董国强, 元海成, 张兴洲, 张楠. 生物补片与自固定补片在腹股沟疝修补术中的临床对照研究[J]. 中华疝和腹壁外科杂志(电子版), 2022, 16(05): 540-543.

Guoqiang Dong, Haicheng Yuan, Xingzhou Zhang, Nan Zhang. Clinical comparative study of biological mesh and self-gripping mesh in inguinal hernia repair[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2022, 16(05): 540-543.

目的

对比猪小肠黏膜下层脱细胞基质生物补片和自固定人工合成聚丙烯补片在腹股沟疝Lichtenstein修补术中应用的临床疗效。

方法

回顾性分析2019年5月至2020年4月于天津市南开医院胃肠疝外科行Lichtenstein修补术的96例初发单侧腹股沟疝患者的临床资料，按照修补材料不同分为SIS组（使用猪小肠黏膜下层脱细胞基质材料生物补片）和SGPP组（使用自固定人工合成聚丙烯补片）。对比2组的一般情况、手术情况及术后并发症情况，评价两种修补材料的安全性和临床疗效。

结果

SIS组46例，SGPP组50例，2组患者一般资料差异无统计学意义（P>0.05）。SIS组手术时间（62.61±6.89）min显著长于SGPP组（59.60±5.13）min（t=2.438，P=0.017）。2组在住院时间、术后第1天疼痛评分、血清肿、切口感染、复发、慢性疼痛、补片感染等方面，差异无统计学意义（P>0.05）。

结论

与自固定人工合成聚丙烯补片相比，猪小肠黏膜下层脱细胞基质生物补片应用于成人腹股沟疝Lichtenstein修补术具有相同的临床疗效及安全性，但其长期疗效仍有待进一步研究。

关键词: 疝，腹股沟, 疝修补术, 生物补片, 并发症
Objective

To compare the clinical efficacy of porcine small intestinal submucosal acellular matrix biological mesh and self-gripping synthetic polypropylene mesh in Lichtenstein repair of inguinal hernia.

Methods

The clinical data of 96 patients with primary unilateral inguinal hernia who underwent Lichtenstein repair in the Department of Gastrointestinal and Hernia Surgery of Tianjin Nankai Hospital from May 2019 to April 2020 were retrospectively analyzed.The patients were divided into the SIS group (using the porcine small intestinal submucosal acellular matrix biological mesh) and the SGPP group (using the self-gripping synthetic polypropylene mesh) according to the different repair materials. The general conditions, surgical conditions, and postoperative complications of the two groups were compared, and the safety and clinical efficacy of the two repair materials were evaluated.

Results

There were 46 cases in the SIS group and 50 cases in the SGPP group. There was no significant difference in the general data between the two groups (P>0.05). The operation time in the SIS group was significantly longer than that in the SGPP group [(62.61±6.89) min vs (59.60±5.13) min. t=2.438, P=0.017]. There was no significant difference between the two groups in hospital stay, pain score on the first postoperative day, seroma, incision infection, recurrence, chronic pain, and mesh infection (P>0.05).

Conclusion

Compared with the self-gripping synthetic polypropylene mesh, the porcine small intestinal submucosal acellular matrix biological mesh has the same clinical efficacy and safety in Lichtenstein repair of inguinal hernia in adults, but its long-term efficacy still needs to be further studied.

Key words: Hernia, inguinal, Herniorrhaphy, Biological mesh, Complication
表1 2组患者一般资料比较
组别 例数 性别[例(%)] 年龄(岁, ±s) 体质量指数(kg/m2, ±s) 疝类别[例(%)] 中华医学会疝分型[例(%)]
男 女 斜疝 直疝 Ⅰ型 Ⅱ型 Ⅲ型 Ⅳ型
SIS组 46 44(95.7) 2(4.3) 36.69±12.21 23.73±3.17 37(80.4) 9(19.6) 18(39.1) 18(39.1) 10(21.7) 0
SGPP组 50 49(98.0) 1(2.0) 41.50±12.56 23.80±2.74 38(76.0) 12(24.0) 21(42.0) 18(36.0) 11(2.2) 0
t/χ2   0.436 1.897 0.114 0.276 0.112
P   0.606 0.061 0.910 0.630 0.965
表2 2组患者手术时间、住院时间、疼痛评分比较（±s）
组别 例数 手术时间(min) 住院时间(d) 术后第1天疼痛评分
SIS组 46 62.61±6.89 3.54±0.68 3.35±0.82
SGPP组 50 59.60±5.13 3.56±0.79 3.42±0.88
t值   2.438 0.109 0.413
P   0.017 0.913 0.68
表3 2组患者术后主要并发症情况比较[例（%）]
组别 例数 血清肿 切口感染 复发 慢性疼痛 补片感染 并发症发生率
SIS组 46 5(10.87) 1(2.17) 0 0 0 6(13.04)
SGPP组 50 2(4.00) 0 0 1(2.00) 0 3(6.00)
χ2   1.673 1.098 0.000 0.930 0.000 1.399
P   0.254 0.295 1.000 0.335 1.000 0.304
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