前入路腹膜前间隙无张力疝修补术对腹股沟疝患者血清基质金属蛋白酶、基质金属蛋白酶组织抑制剂的影响  

Effect of preoperative anterior approach for tension-free hernia repair on serum matrix metalloprotein and tissue inhibitor of metalloproteinases in inguinal hernia patients

作　　者：段红亮 黄光宇 DUAN Hongliang;HUANG Guangyu(Department of General Surgery, The 215 th Hospital of Shaanxi Nuclear Industry, Xi′an, Shaanxi, 712000)

机构地区：[1]陕西省核工业二一五医院普通外科,陕西咸阳712000

出　　处：《实用临床医药杂志》2018年第23期36-39,共4页Journal of Clinical Medicine in Practice

摘　　要：目的探讨腹股沟疝患者行前入路腹膜前间隙无张力疝修补术的疗效、安全性及对血清基质金属蛋白酶(MMP)-2、基质金属蛋白酶组织抑制剂(TIMP)-2的影响。方法选择腹股沟疝患者186例,根据手术方法的不同分为传统组81例与观察组105例。传统组行传统疝修补术,观察组行前入路腹膜前间隙无张力疝修补术。比较2组手术结果、疼痛评分与安全性,并于术后12 h测定2组患者血清中TIMP-2、MMP-2、TIMP-1、MMP-9的水平。结果观察组的住院时间、术中出血量、离床时间与疼痛评分指标显著优于传统组(P <0. 05),2组手术时间差异无统计学意义(P> 0. 05)。观察组尿潴留发生率与1年复发率显著低于传统组(P <0. 05),2组皮下血肿、睾丸炎、切口感染与慢性疼痛的发生率差异无统计学意义(P>0. 05)。术后,观察组患者血清TIMP-2、MMP-2、TIMP-1与MMP-9水平显著低于传统组(P <0. 05)。结论前入路腹膜前间隙无张力疝修补术能够提高疗效,提升安全性,并从根本上降低腹股沟疝的复发率,是临床中较为有效的腹股沟疝治疗术式。Objective To study effect of preoperative anterior approach for tension-free hernia repair on serum serum matrix metalloprotein-2(MMP-2)and tissue inhibitor of metalloproteinases-2(TIMP-2)and its safety in inguinal hernia patients.Methods A total of186inguinal hernia patients were divided into traditional group and observation group according to difference of their surgery methods.The traditional group(n=81)underwent conventional hernia repair,while the observation group(n=105)was treated with tension-free hernia repair in the anterior peritoneal space.The surgical outcomes,pain scores,and safety were compared between the two groups,and the levels of TIMP-2,MMP-2,TIMP-1,and MMP-9in the serum were measured at12h after surgery.Results The length of hospital stay,intraoperative blood loss,bed-off time,and pain score were significantly lower in the observation group than that in the conventional group(P<0.05).There was no significant difference in surgery time in two groups(P>0.05).The urinary retention and1-year recurrence rate in the observation group were significantly lower than that in the traditional group(P<0.05).There was no significant difference in the incidence of subcutaneous hematoma,orchitis,wound infection and chronic pain between the two groups(P>0.05).After operation,the levels of serum TIMP-2,MMP-2,TIMP-1and MMP-9in the observation group were significantly lower than that in the control group(P<0.05).Conclusion The anterior approach of anterior peritoneal space tension-free hernia repair can improve the efficacy and safety,and fundamentally reduce the recurrence rate of inguinal hernia,which is a more effective treatment for inguinal hernia in clinic.

关 键 词：腹股沟疝 无张力疝修补术 血清基质金属蛋白酶-2 基质金属蛋白酶组织抑制剂-2 

分 类 号：R656.2[医药卫生—外科学]