腹膜外间隙内环口缩窄联合TEP对巨大腹股沟斜疝患者疼痛介质、创伤反应及预后复发率的影响  

Effects of Extraperitoneal Space Inner Ring Narrowing Combined with TEP on Pain Mediators,Trauma Response,Prognosis and Recurrence Rate in Patients with Giant Indirect Inguinal Hernia

作　　者：胡国兴 HU Guoxing(The First People’s Hospital of Xianning,Xianning 437000,China)

机构地区：[1]咸宁市第一人民医院,湖北咸宁437000

出　　处：《中外医学研究》2022年第23期64-67,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨腹膜外间隙内环口缩窄联合全腹膜外疝修补术(TEP)对巨大腹股沟斜疝患者疼痛介质、创伤反应及预后复发率的影响。方法:选取2018年2月-2020年4月咸宁市第一人民医院的巨大腹股沟斜疝患者92例,按随机数字表法将其分为观察组(n=46)和对照组(n=46)。对照组采取TEP,观察组采取腹膜外间隙内环口缩窄联合TEP。比较两组手术情况,术前和术后1、3 d创伤反应指标[甲状腺激素(TSH)、皮质醇(Cor)、C反应蛋白(CRP)]、视觉模拟评分法(VAS)评分、疼痛介质[P物质(SP)、五羟色胺(5-HT)]及并发症发生率、复发率。结果:观察组手术时间较对照组长,住院时间、下床活动时间较对照组短(P<0.05)。术后1、3 d两组血清Cor、CRP水平高于术前,血清TSH水平低于术前(P<0.05),但组间比较,差异无统计学意义(P>0.05)。术后1、3 d两组VAS评分、血清SP、5-HT水平呈降低趋势(P<0.05),但组间比较,差异无统计学意义(P>0.05)。观察组并发症发生率2.17%,低于对照组的17.39%(P<0.05);术后随访1年,两组复发率比较,差异无统计学意义(P>0.05)。结论:腹膜外间隙内环口缩窄联合TEP应用于巨大腹股沟斜疝患者,可减少并发症,促进术后康复,且未增加创伤反应、术后疼痛,具有推广价值。Objective:To investigate the effect of extraperitoneal space inner ring narrowing combined with total extraperitoneal hernia repair(TEP)on pain media,trauma response,prognosis and recurrence rate in patients with giant indirect inguinal hernia.Method:A total of 92 patients with huge indirect inguinal hernia in the First People’s Hospital of Xianning from February 2018 to April 2020 were selected and divided into observation group(n=46)and control group(n=46)according to the random number table method.The control group was given TEP,and the observation group was given the extraperitoneal space inner ring narrowing combined with TEP.The operation conditions,preoperative and postoperative 1,and 3 days trauma response indicators[thyroid hormone(TSH),cortisol(Cor),C-reactive protein(CRP)],and visual analog scale(VAS)scores,pain mediators[substance P(SP),serotonin(5-HT)]and the incidence of complications and recurrence were compared between the two groups.Result:The operation time of the observation group was longer than that of the control group,and the hospitalization time and the time of getting out of bed were shorter than those of the control group(P<0.05).At 1 and 3 days after operation,the levels of serum Cor and CRP in the two groups were higher than those before operation,and the level of serum TSH was lower than that before operation(P<0.05),but there were no significant differences between the two groups(P>0.05).The VAS score,serum SP,and 5-HT levels in the two groups decreased at 1 and 3 days after operation,there were no significant differences between the two groups(P>0.05).The incidence of complications in the observation group was 2.17%,lower than 17.39%in the control group(P<0.05);there was no significant difference in the recurrence rate between the two groups after 1-year follow-up(P>0.05).Conclusion:The application of extraperitoneal space inner ring narrowing combined with TEP in patients with giant indirect inguinal hernia can reduce complications,promote postoperative rehabilitation,and do not

关 键 词：内环口缩窄 全腹膜外疝修补术 巨大腹股沟斜疝 创伤反应 疼痛介质 复发率 

分 类 号：R656.21[医药卫生—外科学]