改良医用胶粘合假疝囊技术预防腹腔镜完全腹膜外疝修补术后血清肿的临床研究  

Clinical study on the prevention of seroma after laparoscopic totally extraperitoneal hernia repair by modified medical adhesive and pseudohernia sac technique

作　　者：申亚伟[1] 黄新[1] 李万林[1] Shen Yawei;Huang Xin;Li Wanlin(Department of General Surgery,Xi'an Central Hospital,Xi'an 710000,China)

机构地区：[1]西安市中心医院肝胆疝与腹壁外科,710000

出　　处：《中华疝和腹壁外科杂志（电子版）》2024年第4期410-413,共4页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

摘　　要：目的分析改良医用胶粘合假疝囊技术预防直疝腹腔镜完全腹膜外疝修补术(TEP)后血清肿的临床效果。方法选择2019年2月至2021年3月西安市中心医院肝胆疝与腹壁外科收治的腹股沟直疝患者93例,采用随机数表法随机分为2组。其中试验组患者47例,采用改良医用胶粘合假疝囊技术;对照组患者46例,采用3-0可吸收缝线连续缝合假疝囊,2组均随访至术后12个月。观察2组患者的手术时间、术中出血量、下床时间、平均住院时间、住院费用、术区感染、血清肿发生率、早期疼痛及慢性疼痛发生率。结果试验组在术中出血量、住院时间、住院费用方面和对照组比较,差异无统计学意义(P>0.05);试验组手术时间明显短于对照组,差异有统计学意义(P<0.05)。试验组下床时间明显长于对照组,差异有统计学意义(P<0.05)。试验组和对照组术后均未发生术区感染;对照组有4例患者发生慢性疼痛,试验组无患者发生慢性疼痛,差异有统计学意义(P<0.05)。试验组血清肿发生率4.25%(2/47)低于对照组23.91%(11/46),差异有统计学意义(P<0.05)。试验组术后腹股沟区早期疼痛发生率2.13%(1/47)低于对照组13.04%(6/46),差异有统计学意义(P<0.05)。结论改良医用胶粘合假疝囊技术预防TEP术后血清肿的方法,简单易行、安全可靠。Objective To analyze the clinical effect of modified medical adhesive pseudohernia sac technique in preventing seroma after totally extraperitoneal hernia repair(TEP)for direct hernia.Methods From February 2019 to March 2021,93 patients with direct inguinal hernia who were admitted to Department of Hepatobiliary Hernia and Abdominal Wall Surgery,Xi'an Central Hospital were randomly divided into two groups by random number table method.Among them,47 patients in experimental group were treated with modified medical adhesive pseudohernia sac technology,and 46 patients in the control group were sutured with 3-0 absorbable suture continuously.Both groups were followed up to 12 months after operation.The operation time,intraoperative bleeding,time out of bed,average hospitalization time,hospitalization cost,operation area infection,incidence of seroma,early pain and chronic pain were observed in 2 groups.Results There was no significant difference between the experimental group and the control group in terms of intraoperative bleeding,hospital stay,and hospital costs(P>0.05);The operation time of the experimental group was significantly shorter than that of the control group(P<0.05).The time of getting out of bed in experimental group was significantly longer than that in control group(P<0.05).There was no postoperative infection in the operation area in the experimental group and the control group.There were 4 patients in the control group who had chronic pain,and no patient in the experimental group who had chronic pain,the difference was statistically significant(P<0.05).The incidence of seroma in the experimental group was 4.25%(2/47),which was significantly lower than that in the control group 23.91%(11/46;P<0.05).The incidence of early postoperative pain in the groin area in the experimental group was 2.13%(1/47),which was significantly lower than that in the control group 13.04%(6/46;P<0.05).Conclusion The modified medical adhesive pseudohernia sac technique to prevent seroma after laparoscopic TEP hernia repair

关 键 词：疝 腹股沟 医用胶 疝修补术 腹腔镜 血清肿 

分 类 号：R656.2[医药卫生—外科学]