CAJ | 학술논문

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。
목적：탐토저소장점막하탈세포조직기질보편(porcine small intestine submucosa,SIS)재복고구산환자치료중적응용개치。방법회고성분석2011년5월지2013년12월,상우인민의원362례사용 SIS 보편행복고구산무장력수보술적환자,기록환자수술전후적림상삼수,관찰급분석술중상관정황급술후환자발열、동통평분、활동시간、복발솔급이물감정황。결과술후수방12~43개월,평균(24±12)개월,기중실방15례,복발2례。평균수술시간(60±14) min,술후주원시간5~11 d,평균(7.5±2.6) d。술후 VAS 동통평분분별위술후8 h (4.5±1.5)분、술후7 d (1.4±0.9)분、술후1개월(0.8±0.8)분；술후하상시간위(12±5) h、술후회복일반일상활동시간위(6±5)d、완전회복정상활동시간위(39±38)d；술후1 d 유이물감적환자20례(5.5%),술후7 d 유이물감적환자4례(1.15%),술후3개월유이물감환자2례(0.55%)。1년후균무명현만성동통급명현이물감。안조년령분구,년령≤25세적환자술후동통여기타각년령조간비교,차이무통계학의의(P>0.05),단술후이물감교기타각년령조경미(P<0.05),차술후하상활동시간단(P<0.05)。결론림상응용 SIS 보편행무장력산수보술,수술간편、효과량호、술후서괄성호、창상소、회복쾌、술후병발증소、대년경환자혹자고위감염환자가능경구유우세。
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 May 2011 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.