腹腔镜下经腹腔腹膜前腹股沟疝修补术治疗腹股沟嵌顿疝患者的效果研究  

Effect study of laparoscopic transabdominal preperitoneal inguinal hernia repair on incarcerated inguinal hernia patients

作　　者：魏洪吉[1] WEI Hong-ji(Department of Pancreatic Hernia Surgery,Tai'an Central Hospital,Tai'an 271000,China)

机构地区：[1]山东省泰安市中心医院胰腺疝外科,271000

出　　处：《中国实用医药》2022年第23期6-9,共4页China Practical Medicine

摘　　要：目的 探讨腹股沟嵌顿疝患者采用腹腔镜下经腹腔腹膜前腹股沟疝修补术治疗的效果。方法 80例腹股沟嵌顿疝患者,采用随机摸球法分为观察组与对照组,每组40例。对照组采用常规无张力疝修补术治疗,观察组采用腹腔镜下经腹腔腹膜前腹股沟疝修补术治疗。比较两组患者的临床指标、疼痛评分、应激指标[皮质醇(Cor)、血清β-内啡肽(β-EP)、去甲肾上腺素(NE)]及并发症发生情况。结果 观察组下床活动时间(22.37±6.12)h、首次排气时间(10.21±2.27)h及住院时间(3.57±1.13)d均短于对照组(46.27±9.86)h、(16.07±3.74)h、(6.27±2.59)d,术中出血量(19.23±4.27)ml少于对照组(46.09±6.19)ml,差异具有统计学意义(P<0.05)。观察组术后6、12、24、48 h的疼痛评分分别为(3.08±0.90)、(2.56±0.76)、(2.15±0.70)、(2.01±0.64)分,均明显低于对照组的(4.37±1.02)、(3.81±1.03)、(3.26±0.93)、(3.09±0.89)分,差异具有统计学意义(P<0.05)。术前,两组Cor、β-EP、NE比较差异无统计学意义(P>0.05);术后,两组Cor、β-EP、NE均明显高于术前,但观察组明显低于对照组,差异具有统计学意义(P<0.05)。观察组并发症发生率5.00%低于对照组25.00%,差异具有统计学意义(P<0.05)。结论 腹腔镜下经腹腔腹膜前腹股沟疝修补术应用于腹股沟嵌顿疝患者治疗中可改善临床指标,降低疼痛程度,减少并发症发生情况,且应激反应较小。Objective To discuss the effect of laparoscopic transabdominal preperitoneal inguinal hernia repair on incarcerated inguinal hernia patients.Methods A total of 80 patients with incarcerated inguinal hernia were randomly divided into observation group and control group by random ball-touching method,with 40 cases in each group.The control group was treated with conventional tension-free hernia repair,and the observation group was treated with laparoscopic transabdominal preperitoneal inguinal hernia repair.The clinical indicators,pain score,stress indicators[cortisol(Cor),serumβ-endorphin(β-EP),norepinephrine(NE)]and occurrence of complications were compared between the two groups.Results In the observation group,the off-bed ambulation time(22.37±6.12)h,the first exhaust time(10.21±2.27)h and the hospital stay(3.57±1.13)d were shorter than(46.27±9.86)h,(16.07±3.74)h,and(6.27±2.59)d in the control group;the intraoperative blood loss(19.23±4.27)ml was less than(46.09±6.19)ml in the control group;the differences were all statistically significant(P<0.05).The pain scores of the observation group at 6,12,24,and 48 h after surgery were(3.08±0.90),(2.56±0.76),(2.15±0.70),and(2.01±0.64)points,which were significantly lower than(4.37±1.02),(3.81±1.03),(3.26±0.93),and(3.09±0.89)points in the control group,and the differences were all statistically significant(P<0.05).Before surgery,there was no statistically significant difference in Cor,β-EP and NE between the two groups(P>0.05).After surgery,the Cor,β-EP and NE in the two groups were significantly higher than those before surgery in this group,but the observation group was significantly lower than the control group,and the differences were all statistically significant(P<0.05).The incidence of complications 5.00%in the observation group was lower than 25.00%in the control group,and the difference was statistically significant(P<0.05).Conclusion Application of laparoscopic transabdominal preperitoneal inguinal hernia repair in patients with inguinal inc

关 键 词：腹腔镜下经腹腔腹膜前腹股沟疝修补术 腹股沟嵌顿疝 疼痛程度 应激指标 并发症 

分 类 号：R656.21[医药卫生—外科学]