两种固定方式用于腹腔镜下完全腹膜外腹股沟疝修补术的对比.docVIP

2014-1-25主任加工版 2种固定方式用于腹腔镜下完全腹膜外腹股沟疝修补术的对比 王大川，于颖娟 （绵阳市中心医院，四川 绵阳 621000） [摘要]目的：观察并比较腹腔镜下完全腹膜外腹股沟疝修补术中补片钉合固定与医用生物胶固定的综合效果。方法：将78例行腹腔镜下完全腹膜外腹股沟疝修补术的患者随机分为补片钉合固定组(n=39)和医用生物胶固定组(n=39)，比较2组手术时间、术中出血、术后术区疼痛2组患者顺利，无中转其他术式手术时间(P＞0.05)出血量＜0.05[中图分类号]R [文献标志码]A doi:10.11851/j.issn.1673-1557.2014.01.0 Clinical Outcomes of Mesh Fixation with Staple Versus Medical Adhesive for Laparoscopic Inguinal Hernia Repair Wang Dachuan，Yu Yingjuan (Mianyang Central Hospital，Shichuan Mianyang 621000，ChinaAbstract]Objective:To compare mesh fixation with staple versus medical adhesive for laparoscopic inguinal hernia repair.Methods:78 patients with inguinal hernia were randomized into two groups: mesh fixation with staple group(n=39) and mesh fixation with medical adhesive group(n=39).Surgery time,blood loss and pain,and incidence of mesh dislocation and recurrent hernia were compared between the two groups.Results:All patients had successful surgery.There was no significant difference in surgery time between the two groups(P＞0.05).However,score of pain in medical adhesive group was lower than that in staple group, and blood loss in medical adhesive group was less than that in staple group(all P＜All patients had no mesh dislocation and recurrent hernia within 3 months after surgery.Conclusion:Mesh fixation with medical adhesive is superior to staple in reducing blood loss,relieving pain for laparoscopic inguinal hernia repair,and worthy of further application. [Key words]inguinal hernia;laparoscopy;mesh repair;medical adhesive 目前多数观点认为腹股沟疝环缺损直径＞4 cm则应固定补片，但是采用何种方式固定仍有不同意见[1]。钉合法是腹股沟疝修补术中广泛使用的补片固定方式，尽管技术已经非常成熟，但是仍然存在损伤神经血管的风险，且钉合器械的费用较贵[2-3]。近年来国内外对补片的固定方式已进行了许多探索，新材料的开发和使用日益受到重视[4]。本研究旨在比较腹腔镜下完全腹膜外腹股沟疝修补术中补片钉合固定与医用生物胶固定的综合效果，从而评价不同补片固定方式的临床应用价值。 1 资料与方法 1.1 一般资料 本次研究纳入2010年3月至2013年1月间收治的腹股沟疝患者78例，其中：男71例，女7例；年龄19～72岁，平均65.6岁；根据Gilbert疝分型分为Ⅱ型者41例，Ⅲ型者20例，Ⅳ型者9例，Ⅵ型者7例，Ⅶ型者1例。所有患者均行腹腔镜下完全腹膜外补片植入术。补片植入后随机分为钉合固定组和医用胶固定组，每组各39例。2组患者在性别、年龄、病程、疝分型等方面无显著性差异（(P＞0.05)放置补片根据术中所见腹股沟解剖情况将经裁剪大小聚