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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) ›› 2023, Vol. 17 ›› Issue (01) : 24 -27. doi: 10.3877/cma.j.issn.1674-392X.2023.01.007

临床论著

两种补片在嵌顿性腹股沟疝中的疗效
张梓榕1, 陈富强1, 郭迎凤1, 周昊1, 韩硕1, 陈杰1,†()   
  1. 1. 100043　首都医科大学附属北京朝阳医院疝和腹壁外科
  • 收稿日期:2022-10-04 出版日期:2023-02-18
  • 通信作者: 陈杰

Efficacy of two kinds of mesh in incarcerated inguinal hernia

Zirong Zhang1, Fuqiang Chen1, Yingfeng Guo1, Hao Zhou1, Shuo Han1, Jie Chen1,†()   

  1. 1. Department of Hernia and Abdominal Wall Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100043, China
  • Received:2022-10-04 Published:2023-02-18
  • Corresponding author: Jie Chen
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引用本文：

张梓榕, 陈富强, 郭迎凤, 周昊, 韩硕, 陈杰. 两种补片在嵌顿性腹股沟疝中的疗效[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(01): 24-27.

Zirong Zhang, Fuqiang Chen, Yingfeng Guo, Hao Zhou, Shuo Han, Jie Chen. Efficacy of two kinds of mesh in incarcerated inguinal hernia[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2023, 17(01): 24-27.

目的

探讨比较生物补片和合成补片治疗急性嵌顿性腹股沟疝的安全性和有效性。

方法

收集2017-2021年在首都医科大学附属北京朝阳医院疝和腹壁外科因嵌顿性腹股沟疝行急诊疝修补术患者546例的人口学资料、手术资料及术后随访资料。依使用补片的不同将受试者分为生物补片组（62例）和合成补片组（484例），并对2组患者的在院及术后随访情况进行回顾性分析。

结果

2组患者手术时间、住院天数差异均无统计学意义（P>0.05）。生物补片组住院费用高于合成补片组（P<0.05）。术后随访10~48个月，共发生并发症153例，其中术后血清肿106例，慢性疼痛29例，伤口感染8例，复发5例，术后脑梗死2例，脓毒血症3例。2组患者主要预后指标差异无统计学意义。

结论

2种补片在嵌顿性腹股沟疝急诊手术中应用均安全有效，生物补片较合成补片无明显优势。

关键词: 疝，腹股沟, 疝修补术, 补片, 回顾性研究
Objective

To investigate and compare the security and efficacy of biologic mesh and synthetic mesh when used in acute incarcerated groin hernias.

Methods

546 patients with incarcerated groin hernias who received hernioplasty with mesh in the Department of Hernia and Abdominal Wall Surgery, Beijing Chaoyang Hospital, Capital Medical University from 2017 to 2021 were divided into the biologic mesh group (62 cases) and synthetic mesh group (484 cases). The follow-up of the two patients was retrospectively analyzed.

Results

There was no significant difference in operative time and hospitalization days between the two groups (P>0.05). Hospitalization expense in biologic mesh group is significantly higher than that in synthetic group (P<0.05). After a follow-up range from 10 to 48 months, a total of 153 complications occurred in our study, including seroma in 106, chronic pain in 29, wound infection in 8, recurrence in 5, postoperative cerebral infarction in 2, and sepsis in 3. There was no significant difference in the main prognostic indicators between the two groups (P>0.05).

Conclusion

Two kinds of mesh are both effective and safe when used in emergency surgery for incarcerated inguinal hernias, and biologic mesh has no obvious advantages compared to synthetic mesh.

Key words: Hernia, inguinal, Mesh, Biologic mesh, Herniorrhaphy, Retrospective study
表1 2组患者的人口学资料比较[例（%）]
组别 例数 性别 年龄(岁,±s) 体质量指数(kg/m2,±s) ASA分级 吸烟 高血压 糖尿病 心肺系统疾病 肝肾功能不全
男性 女性 Ⅰ~Ⅱ Ⅲ~Ⅳ
生物补片组 62 52(83.9) 10(16.1) 51.13±24.22 23.14±3.69 57(91.94) 5(8.06) 6(9.68) 10(16.13) 10(16.13) 9(14.52) 5( 8.06)
合成补片组 484 402(83.1) 82(16.9) 68.07±16.45 23.09±3.66 393(81.20) 91(18.80) 164(33.88) 201(41.53) 145(30.00) 151(31.20) 60(12.40)
t/χ2   0.026 7.180 0.093 4.372 15.020 14.954 5.171 7.383 0.984
P   0.872 0.000 0.926 0.037 0.000 0.000 0.023 0.007 0.321
表2 2组患者术中发现嵌顿情况[例（%）]
组别 例数 类型 内容物 切除内容物
嵌顿疝 绞窄疝 网膜 肠管 网膜 小肠 结肠 阑尾 总计
生物补片组 62 15(24.19) 47(75.81) 18(29.03) 44(70.97) 4(6.45) 3(4.84) 0 0 7(11.29)
合成补片组 484 108(22.31) 376(77.69) 134(27.69) 350(72.31) 9(1.86) 19(3.93) 4(0.83) 1(0.21) 33(6.82)
χ2   0.111 0.050   2.873
P   0.739 0.824   0.412
表3 2组患者手术相关指标及术后并发症比较[例（%）]
组别 例数 TAPP 手术时间(min,±s) 住院时间(d,±s) 住院费用(元,±s) 血清肿 慢性疼痛 切口感染 复发
生物补片组 62 19(30.65) 75.66±30.54 4.47±3.01 18 632.88±8 220.48 13(20.97) 4(6.45) 1(1.61) 1(1.61)
合成补片组 484 157(32.44) 68.57±30.11 5.08±4.30 12 832.76±8 185.12 93(19.21) 25(5.17) 7(1.45) 4(0.83)
t/χ2   0.081 1.742 1.084 3.554 0.108 0.015 0.000 /
P   0.776b 0.082a 0.279a 0.001a 0.743b 0.901d 1.000d 0.454c
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