不同类型网片应用于李金斯坦腹股沟疝修补术疗效的前瞻性研究  

Efficacies of different meshes in Lichtenstein repair for inguinal hernia： a prospective study

作　　者：王荫龙[1] 张新[1] 满艺[1] 谢加东[1] 

机构地区：[1]天津市人民医院疝和腹壁外科,300121

出　　处：《中华消化外科杂志》2015年第10期818-822,共5页Chinese Journal of Digestive Surgery

摘　　要：目的：比较采用聚丙烯聚乳酸复合网片、聚酯网片、聚丙烯网片行李金斯坦腹股沟疝修补术的临床疗效。方法：选取2012年2月至2013年5月天津市人民医院收治的1080例原发性单侧腹股沟疝患者进行前瞻性研究。采用随机对照研究方法，将入组患者按随机数字表法分为ProGrip组（采用聚丙烯聚乳酸复合网片）、PET组（采用聚酯网片）和PP组（采用聚丙烯网片）。患者在局部麻醉下采用标准的李金斯坦无张力疝修补术。采用门诊和电话方式进行随访，随访时间截至2014年5月。随访内容包括并发症发生情况、术后疼痛情况及术后健康相关的生命质量。主要观察指标包括：固定网片时间，手术时间，疝复发情况；术后1周、1个月、6个月、12个月疼痛程度，采用数字评价量表（NRS）评估；术后1个月患者健康相关的生命质量，采用SF-36问卷调查，包括生理机能、生理职能、躯体疼痛、一般健康状况、精力、社会功能、情感职能、精神健康8项。正态分布的计量资料以±s表示，多组间比较采用方差分析，两组间比较采用t检验；偏态分布的计量资料以M（范围）表示，重复测量数据采用重复测量方差分析。计数资料比较采用χ2检验和Fisher确切概率法。采用KaplanMeier法计算术后中、重度疼痛率，Logrank检验进行分析。结果：筛选出符合条件的患者1 022例，其中ProGrip组患者367例，PET组346例，PP组309例。ProGrip组、PET组、PP组患者固定网片时间分别为（1.3±0.5）min、（4.9±0.9）min、（5.0±0.9）min，手术时间分别为 （30±5）min、（45±7）min、（44±7）min，3组上述两个指标比较，差异均有统计学意义（F=6.21,4.33，P〈0.05）。固定网片时间和手术时间ProGrip组与PET组比较，差异有统计学意义（t=1.36，4.39，P〈 0.05）；ProGrip组与PP组比较，差异有统计学意义（t=2.67,2.99，P〈0.05）Objective：To compare the clinical efficacies of polypropylenepolyglactic composite mesh, polyester mesh, polypropylene mesh in Lichtenstein repair for inguinal hernia. Methods：The clinical data of 1080 patients with primary unilateral inguinal hernia who were admitted to the Tianjin People′s Hospital from February 2012 to May 2013 were prospectively analyzed. A randomized controlled study was performed based on a random numble table. All the patients were allocated into the ProGrip group （Parietex ProGrip TM SelfFixating Mesh）, PET group （Parietex TM Lightweight Monofilament Polyester Mesh） and PP group （Bard TM Soft Mesh）. Patients received standard Lichtenstein tensionfree repair under local anesthesia and were followed up by outpatient examination and telephone interview till May 2014. The indexs observed during the followup included occurrence of complications, post operative pain and postoperative healthrelated quality of life. The following indexes were recorded： time of mesh fixation, operation time, hernia recurrence, pain degree at postoperative week 1 and month 1, 6, 12 by numerical rating scale （NRS）, quality of life at postoperative month 1 by SF-36 questionnaire survey including physical function, role physical, body pain, general health, vitality, social function, role emotional, mental health. Measurement data with normal distribution were presented as x±s. Comparisons among groups were analyzed by ANOVA and pairwise comparison by t test. Measurement data with skewed distribution were presented as M （range） and repeated measurement data were analyzed using the repeated measures ANOVA. Count data were evaluated by the chisquare test and Fisher exact probability. Postoperative moderate and severe pain rates were evaluated by the KaplanMeier method and analyzed by the Logrank test. Results：There were 1 022 patients screened for eligibility including 367 patients in the ProGrip group, 346 patients in the PET group and 309 patients in the PP group. The time of mesh fixatio

关 键 词：腹股沟疝 李金斯坦疝修补术 自固定网片 聚酯网片 聚丙烯网片 

分 类 号：R656.21[医药卫生—外科学]