【摘要】 目的探讨猪小肠黏膜下脱细胞组织基质补片(porcine small intestine submucosa,SIS)在腹股沟疝患者治疗中的应用价值。方法回顾性分析2011年5月至2013年12月,上虞人民医院362例使用SIS补片行腹股沟疝无张力修补术的患者,记录患者手术前后的临床参数,观察及分析术中相关情况及术后患者发热、疼痛评分、活动时间、复发率及异物感情况。结果术后随访12~43个月,平均(24±12)个月,其中失访15例,复发2例。平均手术时间(60±14)min,术后住院时间5~11 d,平均(7.5±2.6)d。术后VAS疼痛评分分别为术后8 h(4.5±1.5)分、术后7 d(1.4±0.9)分、术后1个月(0.8±0.8)分;术后下床时间为(12±5)h、术后恢复一般日常活动时间为(6±5)d、完全恢复正常活动时间为(39±38)d;术后1 d有异物感的患者20例(5.5%),术后7 d有异物感的患者4例(1.15%),术后3个月有异物感患者2例(0.55%)。1年后均无明显慢性疼痛及明显异物感。按照年龄分区,年龄≤25岁的患者术后疼痛与其他各年龄组间比较,差异无统计学意义(P>0.05),但术后异物感较其他各年龄组轻微(P<0.05),且术后下床活动时间短(P<0.05)。结论临床应用SIS补片行无张力疝修补术,手术简便、效果良好、术后舒适性好、创伤小、恢复快、术后并发症少、对年轻患者或者高危感染患者可能更具有优势。更多还原

【Abstract】 Objective To investigate the value of Porcine Small intestine Submucosa( SIS)acellular tissue matrix mesh in the treatment of inguinal hernia. Methods A retrospective observation was conducted on 362 patients with inguinal hernia who received tension-free repair with SIS mesh from May2011 to December 2013 in the People’ s Hospital of Shangyu. Clinical parameters of patients were recorded before and after operation. Operative variables,postoperative fever,pain score,activity time,recurrence rate and foreign body sensation were analyzed. Results The follow-up period varied from 12 to 43 months[mean of( 24 ± 12) months],15 cases were lost of follow up and 2 cases were recurred. The mean operation time were( 60 ± 14) minuntes and the length of hospital stay ranged 5 to 11 days [mean of( 7. 5 ± 2. 6) days]. The postoperative VAS pain score were( 4. 5 ± 1. 5),( 1. 4 ± 0. 9),and( 0. 8 ±0. 8) at 8 hours,1week and 1 month,respectively. The postoperative out-of-bed time were( 12 ±5) hours,daily activity time were( 6 ± 5) days and complete recovery activity time were( 39 ± 38) days.20 patients( 5. 5%),4 patients( 1. 15%) and 2 patients( 0. 55%) had foreign body sensation at 1 day,1 week and 3 months,respectively. A year later,all patients had no obvious chronic pain and foreign body sensation. As divided the patients into different age group,the group younger than 25 years old did not exhibit significant difference in VAS pain score compared with the other age group( P > 0. 05). However,the former had slighter foreign body sensation( P < 0. 05) and shorter recovery activity time( P < 0. 05).Conclusion Tension-free hernia repair with SIS mesh is a convenient procedure and has good outcome,which shows advantages of good postoperative comfortable feeling,less surgical trauma,fast recovery,less complication. SIS mesh tension-free repair is the prior choice for young patients or those at high risk of infection.更多还原