摘要
目的 通过与无创胶水固定方式的比对,观察腹腔镜下经腹腔腹膜前间隙疝修补术(TAPP)中缝合固定补片的安全性和可靠性.方法 2021年9月至2022年6月于首都医科大学附属北京积水潭医院招募120例单侧腹股沟疝和股疝患者并随机分为观察组和对照组,每组60例.所有患者均经腹腔镜下TAPP治疗,观察组术中应用"三针法"缝合固定补片,对照组使用医用胶水固定补片.所有患者术后均随访至少6个月.比较两组患者术中情况和术后治疗结果.结果 两组患者术前基线资料比较差异无统计学意义(P＞0.05).观察组术中缝合固定时间长于对照组,差异有统计学意义(P＜0.05),而两组术中出血量,术后第1、4、7天的疼痛数字分级法(NRS)评分,慢性疼痛发生率及血清肿发生率比较差异均无统计学意义(P＞0.05).两组无围手术期严重并发症发生,且均未出现复发病例.结论 腹腔镜下TAPP术中采用"三针法"缝合固定补片是一种安全可靠且便于实施的操作方法,与医用胶水固定相比不增加术后疼痛和慢性疼痛的发生率,值得临床应用.
Abstract
Objective To introduce a suture fixation way of patch in laparoscopic transabdominal preperitoneal prosthesis(TAPP),and to verify the safety and reliability of this method by comparing with glue fixation.Method After recruiting and screening,120 patients were finally enrolled from September 2021 to June 2022,and randomly divided into the experimental group and the control group,with 60 patients in each group.All patients underwent TAPP surgery for inguinal hernia.In the trial group,the"three-stitches method"was used to fix the patch,and in the control group,the chemical glue was used to fix the patch.All patients were followed up for no less than 6 months.The intraoperative conditions and postoperative treatment results of the two groups were compared.Result There was no significant difference in the baseline data between the two groups.The fixation time of the experimental group was longer than that of the control group,and the difference was statistically significant(P＜0.05).However,there was no significant difference in the amount of intraoperative blood loss,NRS scores at 1,4,7 days after operation,the incidence of chronic pain,and seroma between the two groups(P＞0.05).No serious perioperative complications occurred in the two groups,and no recurrence was found.Conclusion The"three-stitches technique"is a safe,reliable and cost-effective way for the repair of defects.Compared with the chemical glue fixation method,it has a wider range of application,and does not increase the incidence of postoperative pain and chronic pain.
基金项目
首都医科大学附属北京积水潭医院院级科研基金(YGQ-202220)
NETL
NSTL
万方数据