生物补片在腹股沟疝修补中的应用

doi:10.3877/cma.j.issn.1674-392X.2026.01.018

目的

分析生物补片在腹股沟疝修补术中的应用效果。

方法

收集2019年1月至2022年1月在吉林大学第二医院接受李金斯坦腹股沟疝修补术的男性单侧疝患者，以使用生物补片或合成补片为标准分成2组，比较2组患者住院费用、手术时间、麻醉方式、术后住院时间、术后恢复日常活动时间以及手术后的并发症。

结果

本研究纳入患者188例，其中生物补片组86例，合成补片组102例。2组患者住院费用和手术时间比较，差异有统计学意义（P<0.05）；而麻醉方式、术后住院时间及术后恢复日常活动时间比较，差异无统计学意义（P>0.05）；2组患者异物感、术后慢性疼痛以及并发症总数比较，差异有统计学意义（P<0.05）；而术后发热、术后切口感染、补片感染、血清肿、术后尿潴留、疝复发和术后早期疼痛比较，差异无统计学意义（P>0.05）。

结论

在李金斯坦疝修补手术中，与合成补片相比，生物补片虽然住院费用较高、手术时间较长，但其显著改善了患者术后异物感和慢性疼痛情况，并降低了患者术后并发症的发生率。

关键词: 疝，腹股沟, 疝修补术, 生物补片, 合成补片

Objective

To evaluate the clinical outcomes of biological meshes in inguinal hernia repair.

Methods

Male patients with unilateral inguinal hernia who underwent Lichtenstein repair at the Second Hospital of Jilin University between January 2019 and January 2022 were retrospectively collected. Patients were assigned to a biological mesh group or a synthetic mesh group according to the mesh used. Hospitalization costs, operative time, anesthesia modality, postoperative length of stay, time to return to normal daily activities, and postoperative complications were compared between the two groups.

Results

A total of 188 patients were included, with 86 in the biological mesh group and 102 in the synthetic mesh group. Significant between-group differences were observed in hospitalization costs and operative time (both P<0.05). No significant differences were found in anesthesia modality, postoperative length of stay, or time to return to normal daily activities (all P>0.05). The biological mesh group had significantly lower rates of foreign-body sensation, chronic postoperative pain, and overall postoperative complications (all P<0.05). However, there were no significant differences in postoperative fever, surgical site infection, mesh infection, seroma, postoperative urinary retention, hernia recurrence, or early postoperative pain (all P>0.05).

Conclusion

In Lichtenstein inguinal hernia repair, compared with synthetic mesh, biological mesh is associated with higher hospitalization costs and longer operative time, but it significantly reduces postoperative foreign-body sensation and chronic pain and decreases the overall incidence of postoperative complications.

Key words: Hernia, inguinal, Hernionhaphy, Biological mesh, Synthetic mesh

表1 2组患者一般资料比较

组别	例数	年龄[岁,M(Q₁,Q₃)]	体重指数(kg/m²,±s)	发病时间[月,M(Q₁,Q₃)]	合并基础疾病[例(%)]	疝分型[例(%)]			疝类型[例(%)]		疝位置[例(%)]
组别	例数	年龄[岁,M(Q₁,Q₃)]	体重指数(kg/m²,±s)	发病时间[月,M(Q₁,Q₃)]	合并基础疾病[例(%)]	Ⅰ型	Ⅱ型	Ⅲ型	直疝	斜疝	左侧	右侧
生物补片组	86	51(30,79)	23.59±3.29	7(1,24)	20(23.3)	39(45.3)	42(48.8)	5(5.9)	11(12.8)	75(87.2)	32(37.2)	54(62.8)
合成补片组	102	59(52,65)	23.91±3.05	7(1,15)	27(26.5)	34(33.3)	59(57.9)	9(8.8)	20(19.6)	82(80.4)	36(35.3)	66(64.7)
t/z/χ²值		-1.879	-0.703	-0.329	0.257	3.007			1.575		0.074
P值		0.06	0.483	0.743	0.736	0.218			0.240		0.879

表1 2组患者一般资料比较

组别	例数	年龄[岁,M(Q₁,Q₃)]	体重指数(kg/m²,±s)	发病时间[月,M(Q₁,Q₃)]	合并基础疾病[例(%)]	疝分型[例(%)]			疝类型[例(%)]		疝位置[例(%)]
组别	例数	年龄[岁,M(Q₁,Q₃)]	体重指数(kg/m²,±s)	发病时间[月,M(Q₁,Q₃)]	合并基础疾病[例(%)]	Ⅰ型	Ⅱ型	Ⅲ型	直疝	斜疝	左侧	右侧
生物补片组	86	51(30,79)	23.59±3.29	7(1,24)	20(23.3)	39(45.3)	42(48.8)	5(5.9)	11(12.8)	75(87.2)	32(37.2)	54(62.8)
合成补片组	102	59(52,65)	23.91±3.05	7(1,15)	27(26.5)	34(33.3)	59(57.9)	9(8.8)	20(19.6)	82(80.4)	36(35.3)	66(64.7)
t/z/χ²值		-1.879	-0.703	-0.329	0.257	3.007			1.575		0.074
P值		0.06	0.483	0.743	0.736	0.218			0.240		0.879

表2 2组患者临床指标比较

组别	例数	住院费用[元,M(Q₁,Q₃)]	手术时间[min,M(Q₁,Q₃)]	麻醉方式[例(%)]			术后住院时间[d,±s]	术后恢复日常活动时间[h,±s]
组别	例数	住院费用[元,M(Q₁,Q₃)]	手术时间[min,M(Q₁,Q₃)]	局部浸润麻醉	腰硬联合麻醉	全身麻醉	术后住院时间[d,±s]	术后恢复日常活动时间[h,±s]
生物补片组	86	18 885.02(16 780.63,21 473.77)	71.25(60.00,80.00)	0(0.0)	70(81.4)	16(18.6)	2.43±0.96	48.94±4.40
合成补片组	102	15 488.43(13 333.32,17 370.29)	66.17(55.00,80.00)	4(3.9)	70(68.6)	28(27.5)	2.18±0.89	48.57±4.37
t/z/χ²值		-6.236	-2.347	5.954			1.85	0.581
P值		<0.001	0.019	0.051			0.066	0.562

表2 2组患者临床指标比较

组别	例数	住院费用[元,M(Q₁,Q₃)]	手术时间[min,M(Q₁,Q₃)]	麻醉方式[例(%)]			术后住院时间[d,±s]	术后恢复日常活动时间[h,±s]
组别	例数	住院费用[元,M(Q₁,Q₃)]	手术时间[min,M(Q₁,Q₃)]	局部浸润麻醉	腰硬联合麻醉	全身麻醉	术后住院时间[d,±s]	术后恢复日常活动时间[h,±s]
生物补片组	86	18 885.02(16 780.63,21 473.77)	71.25(60.00,80.00)	0(0.0)	70(81.4)	16(18.6)	2.43±0.96	48.94±4.40
合成补片组	102	15 488.43(13 333.32,17 370.29)	66.17(55.00,80.00)	4(3.9)	70(68.6)	28(27.5)	2.18±0.89	48.57±4.37
t/z/χ²值		-6.236	-2.347	5.954			1.85	0.581
P值		<0.001	0.019	0.051			0.066	0.562

表3 2组患者术后并发症发生情况比较[例（%）]

组别	例数	术后发热(术后24 h)	术后切口感染(术后7 d)	补片感染(术后6个月)	血清肿(术后15 d)	术后尿潴留(术后24 h)	异物感(术后6个月)			疝复发(术后24~36个月)	并发症
组别	例数	术后发热(术后24 h)	术后切口感染(术后7 d)	补片感染(术后6个月)	血清肿(术后15 d)	术后尿潴留(术后24 h)	1分	2分	3分	疝复发(术后24~36个月)	并发症
生物补片组	86	4(4.7)	2(2.3)	0(0)	4(4.7)	7(8.1)	23(26.7)	2(2.3)	0(0.0)	0(0.0)	42(48.8)
合成补片组	102	3(2.9)	8(7.8)	3(2.9)	2(2.0)	9(8.8)	37(36.3)	11(10.8)	1(1.0)	2(2.0)	76(74.5)
χ²		0.381	2.821	2.57	1.093	0.028	9.768			1.704	13.159
P值		0.704	0.113	0.251	0.415	1.000	0.012			0.501	0.001

表3 2组患者术后并发症发生情况比较[例（%）]

组别	例数	术后发热(术后24 h)	术后切口感染(术后7 d)	补片感染(术后6个月)	血清肿(术后15 d)	术后尿潴留(术后24 h)	异物感(术后6个月)			疝复发(术后24~36个月)	并发症
组别	例数	术后发热(术后24 h)	术后切口感染(术后7 d)	补片感染(术后6个月)	血清肿(术后15 d)	术后尿潴留(术后24 h)	1分	2分	3分	疝复发(术后24~36个月)	并发症
生物补片组	86	4(4.7)	2(2.3)	0(0)	4(4.7)	7(8.1)	23(26.7)	2(2.3)	0(0.0)	0(0.0)	42(48.8)
合成补片组	102	3(2.9)	8(7.8)	3(2.9)	2(2.0)	9(8.8)	37(36.3)	11(10.8)	1(1.0)	2(2.0)	76(74.5)
χ²		0.381	2.821	2.57	1.093	0.028	9.768			1.704	13.159
P值		0.704	0.113	0.251	0.415	1.000	0.012			0.501	0.001

表4 2组患者术后疼痛情况比较

组别	例数	术后3 d[分,M(Q₁,Q₃)]	术后1周[分,M(Q₁,Q₃)]	术后慢性疼痛(术后6~12个月)[例(%)]
生物补片组	86	3.69(3.00,5.00)	1.47(0.75,3.00)	3(3.5)^a
合成补片组	102	3.77(3.00,5.00)	1.46(0.00,3.00)	15(14.7)^a
z/χ²值		-0.493	-0.031	6.782
P值		0.622	0.973	0.012

表4 2组患者术后疼痛情况比较

组别	例数	术后3 d[分,M(Q₁,Q₃)]	术后1周[分,M(Q₁,Q₃)]	术后慢性疼痛(术后6~12个月)[例(%)]
生物补片组	86	3.69(3.00,5.00)	1.47(0.75,3.00)	3(3.5)^a
合成补片组	102	3.77(3.00,5.00)	1.46(0.00,3.00)	15(14.7)^a
z/χ²值		-0.493	-0.031	6.782
P值		0.622	0.973	0.012

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The application of biological meshes in inguinal hernia repair

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The application of biological meshes in inguinal hernia repair