摘要
目的探讨可吸收止血纱布代替聚丙烯网塞在单侧原发性腹股沟疝Rutkow术中的应用效果。方法经过倾向性匹配评分后选取江苏大学附属高淳医院和南京大学医学院附属鼓楼医院2017年1月—2018年6月行择期单侧原发性腹股沟疝Rutkow手术患者741例,按照随机数字表法分为观察组371例和对照组370例。观察组修补材料为聚丙烯平片及可吸收止血纱布,对照组为聚丙烯平片及网塞。分析两组患者的手术时间、并发症、慢性疼痛及异物感等情况。结果两组术后1 d的白细胞计数、中性粒细胞百分比、血清皮质醇(Cor)、C-反应蛋白(CRP)、白介素-2(IL-2)水平均高于术前,且观察组白细胞计数、Cor、CRP、IL-2水平均低于对照组,差异有统计学意义(P<0.05);观察组术后住院时间、治疗费用、出院时VAS评分以及术后慢性疼痛及异物感发生率均低于对照组,差异有统计学意义(P<0.05)。两组术后2周内的血清肿、补片感染、切口浅表感染、阴囊肿胀、尿潴留、术区皮肤青紫发生率,差异无统计学意义(P>0.05),且两组术后均无真性复发。结论以可吸收纱布替代聚丙烯网塞行Rutkow手术,能降低治疗费用并改善术后慢性疼痛及异物感。
Objective To investigate the effect of absorbable hemostatic gauze replacing polypropylene mesh plug on chronic pain and foreign body reaction after Rutkow.Methods After a propensity matching score,741 patients with primary unilateral inguinal hernia underwent Rutkow were randomly divided into study group(371 cases)and control group(370 cases)from department of hernia and abdominal wall surgery of Naning Drum Tower Hospital and Gaochun People's Hospital from January 2017 to June 2018.The patching materials of the study group were polypropylene plain sheet and absorbable hemostatic gauze,while the control group was polypropylene plain sheet and mesh plug.The operative time,complications,chronic pain and foreign body reaction were analyzed.Results The levels of white blood cell count,percentage of neutrophils,serum cortisol(Cor),C-reactive protein(CRP),and interleukin-2(IL-2)on the first day after operation of the two groups were higher than those in the preoperative period,and the levels of white blood cell count,Cor,CRP and IL-2 in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).The postoperative hospital stay,treatment cost,VAS score at discharge,and the incidence of postoperative chronic pain and foreign body sensation were significantly lower in the study group than in the control group(P<0.05).There was no significant difference in seroma,mesh infection,superficial incision infection,scrotal swelling,urinary retention,operative area skin cyanoplast and true recurrent between the two groups(P>0.05).Conclusion The use of absorbable gauze instead of polypropylene mesh plug in Rutkow surgery can reduce the treatment cost and improve postoperative chronic pain and foreign body reaction.
作者
徐冬
杨飞
张凯
XU Dong;YANG Fei;ZHANG Kai(Department of General Surgery,The Affiliated Gaochun People's Hospital of Jiansu Health Vocational College,Nanjing 21130,China;Department of General Surgery,The Affiliated Gaochun Hospital of Jiangsu University,Nanjing 211300,China;Department of Hernia and Abdominal Wall Surgery,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing 210009,China)
出处
《西部医学》
2024年第11期1676-1680,共5页
Medical Journal of West China
基金
江苏卫生健康职业学院院级科研项目(2021)(JKC2021053)。
