自固定补片与缝合补片在Lichtenstein无张力疝修补术修复腹股沟疝的效果对比

目的探讨Lichtenstein无张力疝修补术中应用自固定补片与缝合补片修复腹股沟疝的效果和安全性。 方法选择2017年1月至2018年7月湖北省公安县人民医院收治的腹股沟疝患者112例，均行Lichtenstein无张力疝修补术。采取随机数字表法将患者分为观察组（自固定补片）和对照组（缝合补片）各56例。比较2组患者手术时间、住院费用、术后异物感、术后疼痛视觉模拟评分法（VAS）]、术后并发症（阴囊积液、切口感染）、复发率等临床指标差异性，观察手术前后生活质量生活质量综合评定问卷-74（GQOLI-74）]变化情况。 结果观察组患者手术时间短于对照组，住院费用高于对照组（P均<0.05）；观察组患者术后1、3、6、9、12个月的异物感发生率明显低于对照组，术后3 d和1、3、6、12个月的VAS评分均低于对照组（P均<0.05）；2组患者术后阴囊积液、切口感染发生率比较差异无统计学意义（P>0.05），随访12个月均未出现复发病例；术后3个月，2组患者GQOLI-74各维度评分均较术前升高（P<0.05），观察组患者躯体功能评分高于对照组（P<0.05）。 结论Lichtenstein无张力疝修补术中应用自固定补片与缝合补片修复腹股沟疝的并发症均较少且无复发情况，使用自固定补片可缩短手术时间，减轻术后疼痛和异物感，有利于改善生活质量，但其住院费用相对较高。

Comparison of effects of self-gripping mesh and suture fixation mesh for Lichtenstein tension-free hernia repair

ObjectiveTo explore the effects and safety of self-gripping patch and suture fixation mesh in inguinal hernia with Lichtenstein tension-free hernia repair. MethodsA total of 112 patients with inguinal hernia admitted to Gong'an County People's hospital from January 2017 to July 2018 were selected. All patients underwent Lichtenstein tension-free hernia repair, and they were divided into observation group (self-gripping mesh) and control group (suture fixation mesh) according to the random number table method, with 56 cases in each group. The operative time, hospitalization cost, postoperative foreign body sensation, postoperative pain visual analogue scale (VAS)], postoperative complications (scrotal effusion, wound infection) and recurrence rate were compared between the two groups. The changes in quality of life General Quality of Life Invemtory-74 (GQOLI-74)] before and after surgery were observed. ResultsThe operative time in observation group was shorter than that in control group, and the hospitalization cost was higher than that in control group (P<0.05). The incidence rate of foreign body sensation in observation group at 1, 3, 6, 9 and 12 months after surgery was significantly lower than that in control group, and the VAS scores at 3 d, 1, 3, 6 and 12 months after surgery were lower than those in control group (P<0.05). There were no statistically significant differences in the incidence rates of scrotal effusion and wound infection between the two groups (P>0.05), and no recurrence occurred at 12 months of follow-up. At 3 months after surgery, the scores of dimensions of GQOLI-74 in the two groups were higher than those before surgery (P<0.05), and the score of body function in observation group was higher than that in control group (P<0.05). ConclusionBoth self-gripping mesh and suture fixation mesh in Lichtenstein tension-free hernia repair have few complications and no recurrence in the repair of inguinal hernia. Self-gripping mesh can shorten the operative time, and reduce postoperative pain and foreign body sensation, and it is conducive to improving the quality of life, but its hospitalization cost is relatively high.