自固定补片对降低TAPP术后慢性疼痛的研究  

Study on reducing chronic pain after TAPP by self-fixing mesh

作　　者：江华 徐旻博 彭清 JIANG Hua;XU Yu-bo;PENG Qing(Department of General Surgery,Yantian District People's Hospital,Shenzhen 518081,China)

机构地区：[1]深圳市盐田区人民医院普通外科,518081

出　　处：《中国实用医药》2023年第8期53-55,共3页China Practical Medicine

基　　金：深圳市盐田区科技计划项目(项目编号YTWS20180328)。

摘　　要：目的探讨自固定补片对降低成人腹腔镜腹股沟疝修补术(TAPP)后慢性疼痛的效果。方法回顾性分析225例行TAPP术治疗的腹股沟疝患者的临床资料,依据术中疝补片的固定方式不同分为ProGrip自固定补片组(治疗组,121例)和聚丙烯补片+疝钉枪固定组(对照组,104例)。治疗组使用ProGrip自固定补片平铺覆盖整个肌耻骨孔,免固定;对照组使用轻型大网孔聚丙烯补片平铺覆盖整个肌耻骨孔,使用疝钉枪固定。比较两组患者手术时间、住院费用、术后血清肿、复发情况及术后不同时间疼痛评分。结果两组手术时间、住院费用、术后血清肿率、复发率比较,差异无统计学意义(P>0.05)。术后1 d、7 d、1个月、3个月、6个月,治疗组疼痛评分分别为(2.0±0.1)、(1.2±0.6)、(0.3±0.4)、(0.2±0.3)、(0.1±0.2)分,均低于对照组的(2.5±0.6)、(1.8±0.7)、(1.1±0.4)、(0.8±0.7)、(0.5±0.6)分,差异有统计学意义(P<0.05)。结论在TAPP术中使用自固定补片能明显减轻患者的术后疼痛,值得进一步研究和推广。Objective To discuss the effect of self-fixing mesh on reducing chronic pain after transabdominal preperitoneal prosthesis(TAPP)in adults.Methods The clinical data of 225 patients with inguinal hernia treated by TAPP were retrospectively analyzed,and were divided into ProGrip self-fixing mesh group(treatment group,121 cases)and polypropylene mesh+hernia nail gun fixing group(control group,104 cases)according to different fixing methods of the intraoperative hernia mesh.In the treatment group,ProGrip self-fixing mesh was used to cover the entire musopubic foramina without fixation;in the control group,lightweight polypropylene mesh was used to cover the entire musopubic foramina and was fixed with a hernia staple gun.The operative time,hospitalization cost,postoperative seroma,recurrence and pain score at different time postoperatively were compared between the two groups.Results There was no statistically significant difference between the two groups in terms of operative time,hospitalization cost,postoperative seroma rate and recurrence rate(P>0.05).The pain scores of the treatment group were(2.0±0.1),(1.2±0.6),(0.3±0.4),(0.2±0.3)and(0.1±0.2)points on postoperative 1 d,7 d,1 month,3 months,and 6 months,which were lower than those of(2.5±0.6),(1.8±0.7),(1.1±0.4),(0.8±0.7),and(0.5±0.6)points in the control group,and the differences were statistically significant(P<0.05).Conclusion The use of self-fixing mesh in TAPP can significantly reduce postoperative pain,which is worthy of further study and promotion.

关 键 词：腹股沟疝 自固定补片 腹腔镜 慢性疼痛 

分 类 号：R656.21[医药卫生—外科学]