TEP与TAPP治疗小儿腹股沟疝的临床效果及血清炎性因子变化分析  

Analysis of the clinical effect of TEP and TAPP surgery in the treatment of inguinal hernia in children and the changes of serum inflammatory factors.

作　　者：陈明 陈云[1] 李昕[1] CHEN Ming;CHEN Yun;LI Xin(Department of Gastrointestinal Pediatric Surgery,Chizhou People's Hospital,Chizhou Anhui 247000,China.)

机构地区：[1]安徽省池州市人民医院胃肠小儿外科,安徽池州247000

出　　处：《临床和实验医学杂志》2021年第9期983-986,共4页Journal of Clinical and Experimental Medicine

基　　金：安徽省自然科学基金项目(编号:1708085MH214)。

摘　　要：目的分析完全腹膜外补片植入术(TEP)与腹腔镜经腹膜前疝修补术(TAPP)治疗小儿腹股沟疝的临床效果及血清炎性因子变化。方法回顾性选取2016年8月至2020年8月安徽省池州市人民医院收治的120例腹股沟疝患儿,以单盲随机抽样法分组,每组60例,对照组采用TAPP治疗,实验组采用TEP治疗。比较2组患儿手术指标、血清炎性因子指标[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)]、术后并发症发生率。结果实验组患儿手术时间[(35.26±3.62)min]、首次下床时间[(1.26±0.16)d]及住院时间[(5.16±0.64)d]均短于对照组[(42.62±4.19)min、(1.69±0.28)d、(6.82±1.64)d],实验组术中出血量[(16.26±3.62)mL]低于对照组[(19.52±4.17)mL],差异均有统计学意义(P<0.05)。实验组患儿术后24 h血清TNF-α、IL-6、hs-CRP水平[(115.26±7.62)ng/L、(12.26±3.62)ng/L、(5.26±1.07)mg/L]均低于对照组[(140.26±10.44)ng/L、(16.82±4.81)ng/L、(11.62±2.85)mg/L],差异均有统计学意义(P<0.05)。实验组术后并发症发生率(3.33%)低于对照组(15.00%),差异有统计学意义(P<0.05)。结论与TAPP比较,TEP在治疗小儿腹股沟疝方面具有手术时间较短、术后恢复快、机体炎症反应轻、并发症发生率较低等优点,值得借鉴。Objective To analyze the clinical effects of total extraperitoneal prosthetic(TEP)and transabdominal preperitoneal prosthesis(TAPP)treatment of inguinal hernia in children and changes inserum inflammatory factors.Methods A retrospective study of 120 children with inguinal hernia admitted to Chizhou People's Hospital in Anhui Province from August 2016 to August 2020 were divided by single-blind random sampling,a total of 60 cases in each group,and the control group were received TAPP treatment,the experimental group were received TEP treatment.The surgical indicators,serum inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP)],and complication rates were compared between the two groups.Results The operation time[(35.26±3.62)min],the time to get out of bed for the first time[(1.26±0.16)d]and the hospitalization time[(5.16±0.64)d]in the experimental group were shorter than those in the control group[(42.62±4.19)min,(1.69±0.28)d,(6.82±1.64)d],the intraoperative blood loss in the experimental group[(16.26±3.62)mL]was lower than that in the control group[(19.52±4.17)mL],the differences were statistically significant(P<0.05).Serum TNF-α,IL-6,hs-CRP factors[(115.26±7.62)ng/L,(12.26±3.62)ng/L,(5.26±1.07)mg/L]in the experimental group 24 h after operation were all lower than those in the control group[(140.26±10.44)ng/L,(16.82±4.81)ng/L,(11.62±2.85)mg/L],the differences were statistically significant(P<0.05).The incidence of complications in the experimental group(3.33%)was lower than that in the control group(15.00%),and the difference was statistically significant(P<0.05).Conclusion Compared with TAPP in the treatment of inguinal hernia in children,TEP has the advantages of shorter operation time,faster postoperative recovery,less inflammation of the body,and lower complication rate.It is worth learning.

关 键 词：小儿腹股沟疝 完全腹膜外补片植入术 腹腔镜经腹膜前疝修补术 炎症反应 

分 类 号：R726.5[医药卫生—儿科]