不同类型脱细胞基质材料生物补片在青少年腹股沟疝修补术中的应用价值  

Application value of different types of acellular matrix graft biological meshes in inguinal hernia repair of adolescents

作　　者：刘静[1] 申英末[1] 陈杰[1] 聂玉胜[1] 赵学飞[1] 朱熠林[1] 王帆[1] 孙立[1] Liu Jing;Shen Yingmo;Chen Jie;Nie Yusheng;Zhao Xuefei;Zhu Yilin;Wang Fan;Sun Li(Department Of Hernia and Abdominal Surgery,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100043,China)

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,100043

出　　处：《中华消化外科杂志》2020年第7期773-778,共6页Chinese Journal of Digestive Surgery

基　　金：北京市卫生系统高层次卫生技术人才培养计划(2015-3-031)。

摘　　要：目的探讨不同类型脱细胞基质材料生物补片在青少年腹股沟疝修补术中的应用价值。方法采用回顾性队列研究方法。收集2013年1月至2018年6月首都医科大学附属北京朝阳医院收治的159例青少年腹股沟疝患者的临床资料;男155例,女4例;中位年龄为15.0岁,年龄范围为13.0~18.0岁。159例患者中,42例行传统疝囊高位结扎术设为传统手术组;61例采用国产交联脱细胞基质材料生物补片行开放Lichtenstein手术设为国产生物补片组;56例采用进口非交联脱细胞基质材料生物补片行开放Lichtenstein手术设为进口生物补片组。观察指标:(1)手术情况。(2)术后恢复情况。(3)随访情况。采用门诊和电话方式进行随访,了解患者术后恢复情况及并发症发生情况。随访时间截至2019年6月。偏态分布的计量资料以M(范围)表示,多组间比较采用Kruskal-Wallis H检验,两两比较采用Nemenyi检验。计数资料以绝对数表示,多组间比较采用χ^2检验或Fisher确切概率法,两两比较采用χ^2检验或Fisher确切概率法。两两比较采用Bonferroni法进行校正。结果(1)手术情况:3组患者均顺利完成腹股沟疝修补术。传统手术组、国产生物补片组、进口生物补片组患者手术时间分别为20 min(10~25 min)、35 min(30~40 min)、35 min(30~40 min),3组患者手术时间比较,差异有统计学意义(χ^2=91.640,P<0.05)。进一步两两比较,传统手术组患者手术时间分别与国产生物补片组和进口生物补片组比较,差异均有统计学意义(P<0.0167)。国产生物补片组患者手术时间与进口生物补片组比较,差异无统计学意义(P>0.05)。(2)术后恢复情况:传统手术组、国产生物补片组、进口生物补片组患者术后疝复发率分别为7.1%(3/42)、0、0,3组比较,差异有统计学意义(χ^2=8.150,P<0.05)。进一步两两比较,传统手术组患者术后疝复发率分别与国产生物补片组和进口生物补片组比较,差异�Objective To investigate the application value of different types of acellular matrix graft biological meshes in inguinal hernia repair of adolescents.Methods The retrospective cohort study was conducted.The clinical data of 159 adolescent patients with inguinal hernia who were admitted to Beijing Chaoyang Hospital affiliated to Capital Medical University from January 2013 to June 2018 were collected.There were 155 males and 4 females,aged from 13.0 to 18.0 years,with a median age of 15.0 years.Of the 159 patients,42 undergoing traditional high ligation of hernia sac were divided into traditional operation group,61 undergoing Lichtenstein hernia repair using domestic cross-linked acellular matrix graft biological meshes were divided into domestic biological mesh group,and 56 undergoing Lichtenstein hernia repair using imported non cross-linked acellular matrix graft biological meshes were divided into imported biological mesh group.Observation indicators:(1)surgical situations;(2)postoperative recovery;(3)follow-up.Follow-up using outpatient examination and telephone interview was performed to detected postoperative recovery and complications of patients up to June 2019.Measurement data with skewed distribution were represented as M(range),comparison between multiple groups was analyzed using the Kruskal-Wallis H test,and paired comparison between groups was analyzed using the Nemenyi test.Count data were described as absolute numbers,comparison between multiple groups was analyzed using the chi-square test or Fisher exact probability,and paired comparison between groups was analyzed using the chi-square test or Fisher exact probability.Comparison between groups was corrected using the Bonferroni method.Results(1)Surgical situations:all the 3 groups underwent inguinal hernia repair successfully.The operation time of the traditional operation group,domestic biological mesh group and imported biological mesh group was 20 minutes(range,10-25 minutes),35 minutes(range,30-40 minutes)and 35 minutes(range,30-40 minutes)

关 键 词：疝 腹股沟疝 脱细胞基质材料生物补片 疗效 青少年 

分 类 号：R726.5[医药卫生—儿科]