腹腔镜钩针法疝环闭合术治疗腹股沟嵌顿性斜疝的疗效及安全性研究  

Efficacy and safety of laparoscopic closure of hernia ring with crochet needle method in the treatment of incarcerated indirect inguinal hernia

作　　者：柴宝军 赵满栋 CHAI Bao-jun;ZHAO Man-dong(Department of Surgery,the First Rongfu Military Hospital of Shaanxi Province,Baoji 721300,Shaanxi,CHINA;Department of Emergency Surgery,Baoji People's Hospital,Baoji 721000,Shaanxi,CHINA)

机构地区：[1]陕西省荣复军人第一医院外科,陕西宝鸡721300 [2]宝鸡市人民医院急诊外科,陕西宝鸡721000

出　　处：《海南医学》2022年第19期2479-2482,共4页Hainan Medical Journal

摘　　要：目的 探讨腹腔镜钩针法疝环闭合术治疗腹股沟嵌顿性斜疝的疗效及安全性。方法 选择2017年11月至2020年11月陕西省荣复军人第一医院收治的46例腹股沟嵌顿性斜疝患者为研究对象,根据随机数表法将患者分为对照组和观察组各23例。对照组患者给予传统开放手术治疗,观察组患者则给予腹腔镜钩针法疝环闭合术治疗。比较两组患者的临床指标、视觉模拟疼痛(VAS)评分,以及术前、术后C反应蛋白(CRP)、白细胞介素-6(IL-6)及健康状况调查简表(SF-36)评分,同时比较两组患者术后并发症发生情况。结果 观察组患者的术中出血量、下床活动时间、住院时间、首次排气时间分别为(13.12±2.31) m L、(21.31±4.11) h、(3.87±0.76) d、(8.13±1.31) h,明显少(短)于对照组的(25.31±5.24) mL、(32.31±3.87) h、(5.76±0.81) d、(13.21±2.01) h,差异均有统计学意义(P<0.05);术后3 d、7 d,两组患者的VAS评分均降低,且观察组分别为(2.14±0.21)分、(1.76±0.11)分,明显低于对照组的(3.65±0.34)分、(2.12±0.28)分,差异均有统计学意义(P<0.05);术后,两组患者的IL-6、CRP浓度均升高,但观察组分别为(28.31±4.18) ng/L、(14.31±2.91) mg/L,明显低于对照组的(35.61±5.11) ng/L、(17.31±3.01) mg/L,差异均有统计学意义(P<0.05);术后,两组患者的生理职能、躯体疼痛、社会功能、情感职能等评分均升高,且观察组分别为(79.31±3.98)分、(77.31±3.15)分、(79.14±5.11)分、(79.45±5.41)分,明显高于对照组的(73.13±4.01)分、(72.13±4.09)分、(70.41±4.91)分、(72.41±6.41)分,差异均有统计学意义(P<0.05);观察组患者的总并发症发生率为4.35%,明显低于对照组的26.09%,差异有统计学意义(P<0.05)。结论 腹腔镜钩针法疝环闭合术治疗腹股沟嵌顿性斜疝创伤小,术后痛苦程度低,且炎症反应小,并发症少,可提高患者生活质量。Objective To investigate the efficacy and safety of laparoscopic closure of hernia ring with crochet needle method in the treatment of incarcerated indirect inguinal hernia.Methods Forty-six patients with incarcerated indirect inguinal hernia treated in the First Rongfu Military Hospital of Shaanxi Province from November 2017 to November 2020 were selected as the research objects.According to the random number table method,the patients were divided into a control group and an observation group,with 23 patients in each group.The patients in the control group were treated with traditional open surgery,and the patients in the observation group were treated with laparoscopic closure of hernia ring with crochet needle method.The clinical indexes,Visual Analogue Scale(VAS) score,preoperative and postoperative C-reactive protein(CRP),interleukin-6(IL-6),and Short Form 36-item Health Survey(SF-36)scores of the two groups were compared.The incidence of postoperative complications of the two groups were also compared.Results The amount of intraoperative bleeding,ambulation time,length of hospital stay,and first exhaust time in the observation group were(13.12±2.31) mL,(21.31±4.11) h,(3.87±0.76) d,and(8.13±1.31) h,which were significantly less(shorter) than(25.31±5.24) m L,(32.31±3.87) h,(5.76±0.81) d,and(13.21±2.01) h in the control group(P<0.05).At 3 and 7 days after operation,the VAS scores of the two groups decreased,and the scores of the observation group were(2.14±0.21) points and(1.76±0.11) points,which were significantly lower than(3.65±0.34) points and(2.12±0.28) points of the control group(P<0.05).After operation,the concentrations of IL-6 and CRP in the two groups increased,but those in the observation group were(28.31±4.18) ng/L and(14.31±2.91) mg/L,which were significantly lower than(35.61±5.11) ng/L and(17.31±3.01) mg/L in the control group(P<0.05).After operation,the scores of physiological function,physical pain,social function,and emotional function of the two groups increased,and the scores

关 键 词：腹股沟嵌顿性斜疝 腹腔镜钩针法疝环闭合术 疼痛 炎症反应 生活质量 并发症 

分 类 号：R656.21[医药卫生—外科学]