脱细胞组织基质材料生物补片治疗6至18岁腹股沟疝患者的疗效分析  

Inguinal hernia repair with acellular tissue matrix patch for pediatric patients aged 6 to 18 years

作　　者：申英末[1] 陈杰[1] 杨硕[1] 刘素君[1] 王明刚[1] 孙立[1] 王帆[1] 朱熠林[1] 

机构地区：[1]首都医科大学附属北京朝阳医院疝和腹壁外科,100020

出　　处：《中华外科杂志》2011年第10期914-917,共4页Chinese Journal of Surgery

基　　金：吴阶平医学基金会临床科研专项基金资助项目（320.6750.09214）

摘　　要：目的探讨脱细胞组织基质材料生物补片在6～18岁腹股沟疝患者治疗中应用的价值。方法选择2009年6月至12月间60例符合入选标准的6～18岁腹股沟疝患者，随机分为试验组和对照组，每组各30例。试验组应用脱细胞组织基质材料生物补片行腹股沟疝Lichtenstein平片无张力修补术，对照组行传统的单纯疝囊高位结扎术治疗。记录两组患者手术前后的临床参数，观察并分析术后并发症发生情况及疝复发情况。结果试验组手术时间（39±4）min，术后24h目测类比疼痛评分法（VAS）评分为（2．8±0．9）分，术后留院时间（31±8）h；对照组手术时间（36±4）min，术后24hVAS评分（2．6±1．0）分，术后留院时间（34±11）h。试验组手术时间长于对照组（t=3．357，P=0．001），而两组术后24hVAS评分和术后留院时间无差异（P〉0．05）。两组随访观察14～20个月，未出现生物材料过敏病例，未出现伤口感染、慢性疼痛或局部异物感。试验组术后出现阴囊积液3例，无复发；对照组出现阴囊积液2例，复发2例。结论在6—18岁儿童和青少年腹股沟疝患者的治疗中，应用生物补片行平片无张力疝修补手术效果良好．不增加术后相关并发痒。Objective To evaluate the safety and efficacy of hernioplasty using acellular tissue matrix patch to repair inguinal hernia of pediatric patients aged 6 to 18 years. Methods Sixty eligible patients aged 6 to 18 years with primary unilateral inguinal hernia were randomly assigned to experimental or control group from June to December 2009. In the experimental group, acellular tissue matrix patch was used during Lichtenstein herniorrhaphy while traditional high ligation of hernial sac was used in the control group. Preoperative and postoperative parameters such as clinical informations of patients, postoperative complications and recurrence rate were recorded and analyzed. Results There were no significant differences between the 2 groups in postoperative length of stay [ （31 ± 8） h vs. （34 ± 11 ） h] and postoperative Visual Analogue Scale Pain Score （2. 8 ±0. 9 vs. 2. 6 ±1.0） （P 〉0. 05）, but the operation time in the experimental group were longer than that in the control group significantly [ （39 ± 4） min vs. （ 36 ± 4） min, t = 3. 357, P = 0. 001 ]. The duration of follow-up ranged from 14 to 20 months. There were no postoperative incisional infection, chronic postoperative pain and local foreign body sensation in two groups. In the experimental group, 3 patients suffered scrotal hydrocele as compared 2 patients in the control group. There was no recurrence in the experimental group as compared 2 patients （6. 7% ） in the control group, which was no significant difference （ P 〉 0. 05 ）. Conclusion Liebtenstein repair for pediatric patients aged 6 to 18 years with acellular tissue matrix patch has good results and with limited postoperative complications.

关 键 词：疝 腹股沟 疝修补术 青少年 脱细胞组织基质 

分 类 号：R656.2[医药卫生—外科学]