带左旋聚乳酸支架的伞状疝修补网片的制备及释放研究  

Preparation and release of umbrella-shaped hernia repair mesh with poly-L-lactic acid stents

作　　者：刘佶瑗[1] 赵渝[1] 周禄科[1] 陈思宇[1] 

机构地区：[1]重庆医科大学附属第一医院重庆市普外科重点实验室,重庆400016

出　　处：《重庆医科大学学报》2013年第4期416-420,共5页Journal of Chongqing Medical University

摘　　要：目的:从可行性上探讨带左旋聚乳酸(poly-L-lactic acid,PLLA)骨架的伞状疝修补网片在腹壁切口疝修补手术中的释放。方法:通过注塑工艺制备PLLA骨架,与疝修补网片整合后进行动物实验。将24只兔子分为A、B两组;A组为实验组,B组为对照组;每组12只。A、B两组人工建立简单腹壁切口疝模型,A组网片的释放采用新型手术方式,B组网片的放置为普通无张力疝修补。测定A、B两组的手术时间、伤口长度、手术并发症、术后感染等。结果:在腹壁缺损面积以及切口疝长度无差异的情况下,A组手术切口长度为(4.09±0.47)cm,B组手术切口长度为(6.05±0.25)cm,二者之间差异有统计学意义(P=0.000);A组手术时间为(41.75±1.60)min,B组手术时间为(73.25±3.84)min,二者之间差异有统计学意义(P=0.000);A组术后出现血肿1例,B组2例。术区感染A组1例,B组3例。术中肠损伤A组无,B组1例。在并发症中差异无统计学意义(血肿:P=0.999,感染:P=0.59,肠损伤:P=0.999)。结论:带PLLA骨架的伞状疝修补网片的新型释放能有效简化手术方式,减小手术伤口,缩短手术时间,也并未引起过多并发症,同时也为腹壁切口疝的手术治疗提供了另外一种新的"介入"式思路和方法。Objective：To study the feasibility of the release way of umbrella-shaped hernia repair mesh with poly-L-lactic acid（PLLA） stents in simple incisional hernia repair surgery.Methods：PLLA stents manufactured by injection molding technique were combined with hernia repair mesh to carry out animal experiment.Twenty-four rabbits were divided into two groups A and B,group A as experimental group（n=12） and group B as control group（n=12）.Simple abdominal wall incisional hernia model was manufactured for groups A and B,group A adopted the new release way with the mesh and group B adopted the ordinary tension-free hernia repair.Operating time,wound length,postoperative complications and postoperative infection between groups A and B were compared.Results：There were significant differences in length of incision between groups A and B,（4.09±0.47） cm vs.（6.05±0.25） cm,P= 0.000.There were significant differences in operating time between groups A and B,（41.75±1.60） min vs.（73.25±3.84） min,P= 0.000.There was 1 case of postoperative hematoma in group A and 2 cases in group B.There were 3 cases of postoperative infection in group B and 1 case in group A.There was 1 case of intestinal injury during the operation in group B and none in group A（hematoma： P=0.999,infection：P=0.59,intestinal injury：P=0.999）.There was no significant difference in the complications between the two groups.Conclusions：New release way of umbrella-shaped hernia repair mesh with PLLA stents can simplify the operation,diminish the length of incision,shorten the operation time without increasing complications;meanwhile,it provides another ‘intervention’ typed idea and method for treating incisional hernia of abdominal wall.

关 键 词：左旋聚乳酸 伞状疝修补网片 释放研究 腹壁切口疝 

分 类 号：R656.2[医药卫生—外科学]