摘要
目的观察比较强生UMS补片与巴德网塞补片对成人腹股沟疝修补术近远期并发症的影响,比较两种补片在成人腹股沟疝中的应用价值。方法使用前瞻性随机对照试验的方法,将272例腹股沟疝患者纳入研究,按照随机数字表法分为试验组和对照组,各136例。两组患者均接受Lichtenstein疝修补术治疗,对照组术中使用强生UMS补片,试验组使用巴德网塞补片。比较两组麻醉苏醒时(T_(1))、出院时(T_(2))、拆线时(T_(3))、术后1个月返诊时(T_(4))的视觉模拟评分(VAS),近远期并发症及复发率。结果随访期间剔除6例,最终试验组132例,对照组134例完成研究。不同补片材料患者的VAS评分有明显差异(χ^(2)=70.12,P<0.05),并且不同时点患者的VAS评分有明显差异(χ^(2)=3207.42,P<0.05),且交互作用有统计学意义(χ^(2)=13.10,P<0.05)。试验组慢性疼痛发生率低于对照组,差异有统计学意义(χ^(2)=4.17,P<0.05);两组患者血肿、尿潴留、异物感、迟发性补片感染、补片位移发生率比较,差异均无统计学意义(χ^(2)分别=0.00、0.00、0.43、1.32、0.00,P均>0.05)。两组患者6个月、12个月复发率及总复发率比较,差异均无统计学意义(χ^(2)分别=0.00、0.00、0.00,P均>0.05)。结论成人腹股沟疝修补术中使用强生UMS补片或巴德网塞补片均能够减少远期复发,尤其巴德网塞补片能够减轻术后疼痛,预防慢性疼痛发生。
Objective To observe the effect of Johnson UMS patch and Bard mesh plug patch on the short-term and long-term complications of adult inguinal hernia repair ment,and compare the application value of the two kinds of patches in adult inguinal hernia.Methods A prospective randomized controlled trial was conducted in 272 patients with inguinal hernia who received Lichtenstein operation.Totally 272 patients were divided into test group and control group according to the random number table,with 136 patients in each group.Both groups of patients received Lichtenstein hernia repair ment.The control group used Johnson UMS patch during the operation,and the test group used Bard mesh plug patch.The degree of pain[visual analogue scale(VAS)scores at anesthesia recovery(T1),discharge(T2),suture removal(T3),and reexamination at 1 month after surgery(T4)],short-term and long-term complications and recurrence rate between the two groups were compared.Results During the follow-up period,6 cases were excluded,with 132 cases in the final test group and 134 cases in the control group completing the study.The VAS scores of patients with different patch materials were significantly different(χ^(2)=70.12,P<0.05).And the VAS scores of patients at different time points were significantly different(χ^(2)=3207.42,P<0.05).The interaction was statistically significant(χ^(2)=13.10,P<0.05).The incidence of chronic pain in the test group was lower than that in the control group,and the difference was statistically significant(χ^(2)=4.17,P<0.05).There was no statistical significant difference in the incidence of hematoma,urinary retention,foreign body sensation,delayed patch infection,and patch displacement between the two groups(χ^(2)=0.00,0.00,0.43,1.32,0.00,P>0.05).There was no statistically significant difference in the total recurrence rate and recurrence rate at 6 and 12 months between the two groups(χ^(2)=0.00,0.00,0.00,P>0.05).Conclusion The use of Johnson UMS patch or Bard mesh plug patch in adult inguinal hernia repair can reduce long-term recurrence,especially Bard mesh plug patch can reduce postoperative pain and prevent chronic pain.
作者
王瑜
尤祥正
蒋智超
林成平
WANG Yu;YOU Xiangzheng;JIANG Zhichao(Department of General Surgery,Linhai Second People's Hospital,Linhai 317016,China)
出处
《全科医学临床与教育》
2023年第7期611-614,共4页
Clinical Education of General Practice
基金
临海市科技局课题(2018YY11)。
