医用胶和钉合固定直疝假性疝囊预防直疝术后血清肿的比较  

Medical Glue and Stapling Fixed False Hernia Sac for Preventing Postoperative Seroma in Patients with Direct Hernia

作　　者：屈坤鹏[1] 司若湟[1] 杨晓军[1] 王斌[1] 高鹏[1] 

机构地区：[1]甘肃省人民医院普外二科,甘肃兰州730000

出　　处：《中国普外基础与临床杂志》2015年第4期443-446,共4页Chinese Journal of Bases and Clinics In General Surgery

基　　金：甘肃省自然科学基金(项目编号:145RJZA1160)~~

摘　　要：目的比较医用胶和钉合固定在腹腔镜经腹腹膜前修补术固定直疝假性疝囊预防直疝修补术后血清肿的效果。方法 94例腹股沟直疝患者,按随机表数字法随机均分为医用胶组和钉合组2组,分别采用医用胶和疝钉合器固定直疝假性疝囊,术后随访2年,分别观察2组患者的手术时间、住院时间、术后第1和第7天的疼痛评分、术后并发症(血清肿、伤口感染、伤口出血)、住院费用以及1年和2年内疝的复发率。结果医用胶组与钉合组比较,其手术时间短〔(35±5.1)min比(41±7.5)min〕、住院时间短〔(4±0.51)d比(5±0.83)d〕、术后疼痛评分低〔第1天(5±0.52)分比(6±0.33)分;第7天(3±0.67)分比(4±0.53)分〕以及住院费用低〔(5 731±560.50)元比(8 715±534.33)元〕,其差异均有统计学意义(P<0.05);而2组术后血清肿及其他并发症发生率和术后1年及2年疝复发率的差异均无统计学意义(P>0.05)。结论采用医用胶固定直疝假性疝囊预防疝修补术后血清肿疗效确切,手术时间短,费用低,宜于在各级医院推广。Objective To compare the effects of medical glue and stapling in the prevention of postoperative seroma for patients undergoing laparoscopic direct hernia repair. Methods Ninty-four patients were randomly by computer generated randomization number divided into two groups： medical glue group（medical glue was used to fix pseudo-direct hernia sac） and stapling group（staple was used to fix pseudo-direct hernia sac）. The time of follow-up was two years. The operative time, length of hospital stay, the pain level on first day and 7th day after operation, postoperative complications（seroma, wound infection, wound bleeding）, hospital costs, and hernia recurrence rate within 2 years were observed. Results The medical glue group compared with the stapling group, the operative time was shorter 〔（35±5.1） min vs.（41±7.5） min〕, hospitalization time was shorter 〔（4±0.51） d vs.（5±0.83） d〕, lower postoperative pain score 〔the first day：（5±0.52） scores vs.（6±0.33） scores;the 7th day：（3±0.67） scores vs.（4±0.53） scores〕, and lower cost in hospital 〔（5 731±560.50） yuan vs.（8 715±534.33） yuan〕, there were significant difference（P〉0.05）. The incidence of seroma and other complications after operation and postoperative 1-year and 2-year hernia recurrence rate showed no significant differences（P0.05）. Conclusions The medical glue has good prevention effects on postoperative seroma for patients undergoing laparoscopic direct hernia surgery, with shorter operative time and lower cost. This method is suitable for all levels of hospitals

关 键 词：医用胶 钉合 直疝 假性疝囊 血清肿 

分 类 号：R656.2[医药卫生—外科学]