评价Prolene补片修补切口疝疗效的前瞻性研究:一项基于医院的研究

Vinod Kumar Jeengar, R. Verma
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引用次数: 0

摘要

背景:腹股沟疝是最常见的类型,约占所有疝的75%。腹股沟疝的病因尚不清楚。疝修补技术通常是基于习惯而非证据根据资料有一个很好的观察,在复发方面,开放补片修复优于缝合修复。本研究的目的是评价聚丙烯补片修补术在切口疝中的疗效。对象和方法:对拉贾斯坦邦比尔瓦拉RVRS医学院及其附属医院群普通外科30例进行前瞻性医院研究。我们随机分配30例患者进行切口疝的缝合修复或补片修复。随访1个月及3个月,按标准方案进行局部体格检查。记录与手术有关的因素,包括手术技术、有无血肿、血肿、感染、裂开。随访于术后1个月和3个月在门诊基础上进行疝气复发。结果:本组病例以40 ~ 49岁年龄组居多,占43.33%。小间隙(0-5cm) 90%的病例和10%的病例有中等间隙。1个月时,A组疼痛发生率为26.66%,B组为20%。A组和b组术后3个月疝复发率分别为28%和4%,差异有统计学意义(P=0.0488*),且A组术后3个月疝复发率均较高,伤口感染发生率为27.27%。大多数感染发生在肥胖患者中(40%)。结论:聚丙烯补片修复术在疝复发方面优于缝线修复术。
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A Prospective Study to Evaluate the Effectiveness of Prolene Mesh Repair in Incisional Hernia: A Hospital Based Study
Background: Inguinal hernia is the most common diversity accounting for roughly 75% of all hernia. The etiology of an inguinal hernia is clearly not understood. The technique of hernia repair is usually based on custom rather than evidence.4 According to data there is a good observation that open mesh repair is better than suture repair in terms of recurrences. The aim of this study to evaluated the effectiveness of prolene mesh rapair in incisional hernia.Subjects and Methods:A prospective hospital based study done on 30 cases in department of general surgery at RVRS medical college & associated group of hospitals, Bhilwara, Rajasthan. We randomly assigned 30 patients to suture repair or mesh repair of an incisional hernia. The patients were followed up by local physical examination at 1 month & 3 months were done as per standard protocol. Factors related to the operation including the surgical technique, presence or absence of seroma, hematoma, infection, dehiscence were recorded. Follow-up of cases was done at 1 month & 3 months after surgery on an outpatient basis for recurrence of hernia.Results:Our study showed that the majority of cases (43.33%) were seen in 40-49 years of age group. Small (0-5cm) gap size 90% cases and 10% cases have medium gap size in our study. Pain present in 26.66% patients in group A and 20% in group B at 1 month. The recurrence of hernia was present in 28% cases in group A and 4% in group B. It was statistically significant (P=0.0488*) at 3 months and the mostly were well built and have 27.27% wound infection present in these type of patients. Mostly infection occurred in obese patients (40%).Conclusion: We concluded that restoration with polypropylene mesh is superior to suture repair group with concern to the recurrence of hernia.
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