老年腹股沟疝患者应用L型腔镜拉钩辅助TAPP治疗对血清MMP-2及β-EP表达水平的影响  

Effects of L-shaped laparoscopic retractor assisted TAPP therapy on serum MMP-2 andβ-EP expression levels in elderly patients with inguinal hernia

作　　者：王利[1] 刘馥男 吕超 Wang Li;Liu Fu-nan;Lu Chao(Department of General Surgery,Tianjin Port Hospital,Tianjin 300456,China)

机构地区：[1]天津港口医院普外科,天津300456

出　　处：《四川生理科学杂志》2023年第5期819-822,共4页Sichuan Journal of Physiological Sciences

摘　　要：目的:探讨老年腹股沟疝患者应用L型腔镜拉钩辅助腹腔镜经腹膜前疝修补术(Laparoscopic preperitoneal hernia repair,TAPP)治疗对血清基质金属蛋白酶-2(Matrix metalloproteinase-2,MMP-2)及总抗氧化能力(Total antioxidant capacity,T-AOC)、β-内啡肽(Beta-endorphins,β-EP)表达水平的影响。方法:选取2019年8月至2022年8月我院收治的68例老年腹股沟疝患者作为研究对象,用随机数字表法将其分对照组和观察组,各34例,对照组接受TAPP手术治疗,观察组接受L型腔镜拉钩辅助TAPP治疗,比较两组患者治疗疗效、围术期指标、血清MMP-2及β-EP指标、疼痛程度、并发症等。结果:观察组住院时间、肛门排气时间、手术用时短于对照组,术中出血量、术后2 d时视觉模拟评分法(Visual analog scoring,VAS)评分明显低于对照组(P<0.05);观察组胰岛素(Insulin,InS)、生长激素(Growth hormone,GH)、T-AOC明显高于对照组,β-EP明显低于对照组(P<0.05);观察组基质金属蛋白酶组织抑制剂-2(Matrix metalloproteinase tissue inhibitor-2,T1MP-2)、基质金属蛋白酶组织抑制剂-1(Matrix metalloproteinase tissue inhibitor-2,T1MP-1)、MMP-2、基质金属蛋白酶-9(Matrix metalloproteinase-9,MMP-9)明显低于对照组(P<0.05);观察组并发症发生率明显低于对照组(P<0.05)。结论:临床用L型腔镜拉钩辅助TAPP治疗老年腹股沟疝患者,能进一步保护机体微环境,促进术后恢复,降低并发症发生几率,疗效理想。Objective:To investigate the effects of L-shaped laparoscopic retractor-assisted Laparoscopic preperitoneal hernia repair(TAPP)therapy on serum matrix metalloproteinase-2(MMP-2)and total antioxidant capacity(T-AOC),Beta-endorphins(β-EP)expression levels in elderly patients with inguinal hernia.Methods:A total of 68 elderly patients with inguinal hernia treated from August 2019 to August 2022 were selected as research objects,and were divide into control group and observation group by random number table method,with 34 cases in each group,the control group received TAPP surgery,and the observation group received L-shaped laparoscopic retractor-assisted TAPP therapy,and the curative effect,perioperative indicators,serum MMP-2 andβ-EP indicators,pain degree,and complications were compared between the two groups.Results:The hospitalization time,anal exhaust time,and operation time in the observation group were shorter than those in the control group,and the intraoperative blood loss and visual analog scoring(VAS)score at 2 days after operation in the observation group were significantly lower than those in the control group(P<0.05).The insulin(InS),growth hormone(GH),and T-AOC in the observation group were significantly higher than those in the control group,andβ-EP in the observation group was significantly lower than that in the control group(P<0.05).The matrix metalloproteinase tissue inhibitor-2(T1MP-2),matrix metalloproteinase tissue inhibitor-1(T1MP-1),MMP-2,Matrix metalloproteinase-9(MMP-9)of the observation group were significantly lower than those of the control group(P<0.05).The incidence of complications in the observation group was significantly lower than the control group(P<0.05).Conclusion:The clinical use of L-shaped laparoscopic retractors to assist TAPP in the treatment of elderly patients with inguinal hernia can further protect the microenvironment of the body,promote postoperative recovery,reduce the incidence of complications,which have an ideal curative effect.

关 键 词：老年腹股沟疝 L型腔镜拉钩 TAPP MMP-2 Β-EP 

分 类 号：R656.21[医药卫生—外科学]