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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 (06) : 672 -676. doi: 10.3877/cma.j.issn.1674-392X.2022.06.014

临床论著

新型非交联与交联生物补片在青少年和青壮年腹股沟疝术中对比研究
刘静1, 劳金涛2, 申英末1,†()   
  1. 1. 100020　首都医科大学附属北京朝阳医院疝和腹壁外科
    2. 100020　北京，首都医科大学第三临床医学院
  • 收稿日期:2022-05-13 出版日期:2022-12-18
  • 通信作者: 申英末
  • 基金资助:
    吴阶平医学基金会临床科研专项资助基金(320.6750.19091-4)

Comparative study of new non-crosslinked biological mesh and crosslinked biological mesh in inguinal hernia repair in adolescents and young adults

Jing Liu1, Jintao Lao2, Yingmo Shen1,†()   

  1. 1. Department of Hernia and Abdominal Wall Surgery, Beijing Chaoyang Hospital Capital Medical University, Beijing 100020, China
    2. The Third Clinical Medical College of Capital Medical University, Beijing 100020, China
  • Received:2022-05-13 Published:2022-12-18
  • Corresponding author: Yingmo Shen
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引用本文：

刘静, 劳金涛, 申英末. 新型非交联与交联生物补片在青少年和青壮年腹股沟疝术中对比研究[J]. 中华疝和腹壁外科杂志(电子版), 2022, 16(06): 672-676.

Jing Liu, Jintao Lao, Yingmo Shen. Comparative study of new non-crosslinked biological mesh and crosslinked biological mesh in inguinal hernia repair in adolescents and young adults[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2022, 16(06): 672-676.

目的

对比研究国产新型非交联脱细胞基质材料生物补片与交联生物补片在青少年和青壮年腹股沟疝治疗中的临床疗效，从而为青少年和青壮年这一特定人群的腹股沟疝治疗提供新材料。

方法

采用单中心、前瞻性、随机对照研究，收集分析首都医科大学附属北京朝阳医院疝和腹壁外科2019年6月至2020年12月收治的120例青少年和青壮年腹股沟疝患者的临床资料，其中男性112例，女性8例，平均年龄32岁（13~45岁）；按照随机数字表法分为2组，60例患者使用国产新型非交联脱细胞基质材料生物补片行李金斯坦疝修补手术，设为试验组，60例患者使用交联生物补片行李金斯坦修补手术，设为对照组，比较2组患者的临床指标。

结果

试验组和对照组的手术时间、术中出血量、住院时间均无统计学差异（P>0.05）；住院费用比较，试验组明显低于对照组，差异有统计学意义（P<0.05）。试验组术后1周血清肿发生率明显高于对照组（38.3% vs 20.0%，P<0.05），但2组患者在术后1个月及3个月血清肿发生率差异无统计学意义（P>0.05）。试验组随访时间（20.17±5.57）个月，对照组随访时间（19.45±5.70）个月，2组患者均未出现慢性疼痛、异物感、睾丸缺血/萎缩、伤口感染、补片感染等术后并发症。

结论

国产新型非交联脱细胞基质材料生物补片治疗青少年和青壮年腹股沟疝安全有效，与交联生物补片临床疗效相当，是治疗青少年和青壮年腹股沟疝所需材料的另一选择。

关键词: 疝，腹股沟, 疝修补术, 生物补片, 疗效
Objective

A comparative study was conducted on the clinical efficacy of domestic new non-crosslinked acellular matrix biological mesh and crosslinked biological mesh in the treatment of inguinal hernia in adolescents and young adults, to provide new materials in treatment of inguinal hernia for this population.

Methods

A single-center, prospective, randomized controlled study was conducted. Clinical data of 120 adolescent and young adults with inguinal hernia who were treated in the Department of Hernia and Abdominal Wall Surgery of Beijing Chaoyang Hospital, Affiliated to Capital Medical University from June 2019 to December 2020 were collected and analyzed. There were 112 males and 8 females with an average age of 32 years (13~45 years). The patients were divided into 2 groups according to the random number table method. 60 patients in experimental group underwent Lichtenstein repair with domestic new non-crosslinked acellular matrix biological mesh; 60 patients in control group underwent Lichtenstein repair with cross-linked biological mesh. Data of clinical indicators of the two groups were compared.

Results

There were no significant differences in operative time, intraoperative blood loss and hospital stay between the experimental group and the control group (P>0.05). The hospitalization cost of the experimental group was significantly lower than that of the control group (P<0.05). Seroma rate in the experimental group at 1 week after operation was significantly higher than that in the control group (38.3% vs 20.0%, P<0.05), but there was no significant difference between the two groups at 1 month and 3 months postoperatively (P>0.05). The follow-up time in experimental group and control group was (20.17±5.57) months and (19.45±5.70) months, respectively. No patients developed postoperative chronic pain, foreign body sensation, testicular ischemia/atrophy, wound infection and mesh infection during the follow-up duration in both groups.

Conclusion

The domestic new non-crosslinked acellular matrix biological mesh is safe and effective in the treatment of inguinal hernia in adolescents and young adults, which is equivalent to the clinical efficacy of crosslinked biological mesh. It is an alternative material for the treatment of inguinal hernia in adolescents and young adults, and worthy of clinical promotion.

Key words: Hernia, inguinal, Herniorrhaphy, Biological mesh, Efficacy
表1 2组患者一般资料比较[例(%)]
组别 例数 年龄(岁,±s) 性别 体质量指数(kg/m2,±s) 美国麻醉医师协会分级 Gilbert分型 疝部位 疝分类 随访时间(月,±s)
男 女 Ⅰ级 Ⅱ级 Ⅱ型 Ⅲ型 Ⅳ型 Ⅴ型 右侧 左侧 斜疝 直疝
试验组 60 31.68±10.00 55(91.7) 5(8.3) 23.98±2.42 39(65.0) 21(35.0) 10(16.7) 45(75.0) 2(3.3) 3(5.0) 34(56.7) 26(43.3) 55(91.7) 5(8.3) 20.17±5.57
对照组 60 33.13± 8.01 57(95.0) 3(5.0) 24.32±2.71 36(60.0) 24(40.0) 9(15.0) 43(71.7) 6(10.0) 2(3.3) 38(63.3) 22(36.7) 52(86.7) 8(13.3) 19.45±5.70
t/χ2   0.843 0.536 0.721 0.320 2.283 0.556 0.776 -0.697
P值   0.401 0.717 0.473 0.572 0.558 0.456 0.378 0.487
表2 2组患者手术指标比较（±s）
组别 例数 手术时间(min) 术中出血量(ml) 住院费用(元) 住院时间(d)
试验组 60 52.53±10.55 2.72±1.54 10 439.84±273.97 1.67±0.71
对照组 60 53.28±10.60 2.80±1.36 14 982.67±334.85 1.73±0.78
χ2   0.388 0.314 -1.883 0.492
P值   0.698 0.754 0.021 0.624
表3 2组患者术后随访指标比较[例（%）]
组别 例数 复发 慢性疼痛 异物感 睾丸缺血/萎缩 切口脂肪液化 伤口感染 补片感染 切口血清肿 死亡
术后1周 术后1个月 术后3个月 术后6个月
试验组 60 1(1.7) 0 0 0 0 0 0 23(38.3) 12(20.0) 6(10.0) 0 0
对照组 60 0 0 0 0 2(3.3) 0 0 12(20.0) 9(15.0) 4( 6.7) 0 0
χ2   1.008       2.034     6.659 0.519 0.436    
P值   1.000       0.496     0.027 0.471 0.509    
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