单孔与双孔腹腔镜疝修补术治疗腹股沟疝患儿的疗效比较及对应激反应和疼痛介质的影响  

Comparison of Efficacy between Single-Hole and Double-Hole Laparoscopic Hernioplasty in the Treatment of Children with Inguinal Hernia and its Influence on Stress Response and Pain Mediator

作　　者：王道喜[1] 李浪[1] 江君[1] 杨鹏[2] 陈强 WANG Dao-xi;LI Lang;JIANG Jun;YANG Peng;CHEN Qiang(Department of Pediatric Surgery,West China Hospital of Sichuan University,Chengdu,Sichuan,610000,China;Department of Pediatric Surgery,Guiyang Maternal and Child Health Hospital,Guiyang,Guizhou,550000,China;Department of Pediatric Surgery,Suining Central Hospital,Suining,Sichuan,629000,China)

机构地区：[1]四川大学华西医院小儿外科,四川成都610000 [2]贵阳市妇幼保健院儿外科,贵州贵阳550000 [3]遂宁市中心医院小儿外科,四川遂宁629000

出　　处：《现代生物医学进展》2023年第14期2650-2654,共5页Progress in Modern Biomedicine

基　　金：四川省科技计划项目(2018SZ0249)。

摘　　要：目的:对比单孔腹腔镜疝修补术(SSLH)与双孔腹腔镜疝修补术(DSLH)治疗腹股沟疝患儿的疗效,并探讨两种手术方式对患儿应激反应和疼痛介质的影响。方法:选择2020年1月至2022年5月期间四川大学华西医院收治的136例腹股沟疝患儿。按照手术方法的不同将患儿分为DSLH组(DSLH,71例)和SSLH组(SSLH,65例)。对比两组患儿的临床指标、应激反应指标[皮质醇(Cor)、去甲肾上腺素(NE)、醛固酮(ALD)]、疼痛介质指标[P物质(SP)、5-羟色胺(5-HT)、β-内啡肽(β-EP)],并观察两组术后并发症发生情况。结果:SSLH组的术中出血量少于DSLH组,下床活动时间、住院时间短于DSLH组,手术时间长于DSLH组(P<0.05)。术后1 d两组Cor、NE、ALD均升高,但SSLH组均低于DSLH组同时间点(P<0.05)。术后1 d两组SP、5-HT均升高,但SSLH组均低于DSLH组同时间点;β-EP下降,但SSLH组高于DSLH组同时间点(P<0.05)。两组并发症发生率组间比较,差异无统计学意义(P>0.05)。结论:与DSLH相比,SSLH治疗腹股沟疝患儿,具有更好的疗效,可改善临床指标,减轻应激反应程度,降低疼痛介质水平。Objective:To compare the efficacy of single-hole laparoscopic hernioplasty(SSLH)and double-hole laparoscopic hernioplasty(DSLH)in the treatment of children with inguinal hernia,and to explore the effect of the two surgical methods on the stress response and pain mediator of children.Methods:136 children with inguinal hernia who were admitted to West China Hospital of Sichuan University from January 2020 to May 2022 were selected.According to different surgical methods,the children were divided into DSLH group(DSLH,71 cases)and SSLH group(SSLH,65 cases).The clinical indexes,stress response indexes[cortisol(Cor),norepinephrine(NE),aldosterone(ALD)],pain mediator indexes[substance P(SP),5-hydroxytryptamine(5-HT),β-endorphin(β-EP)]of children in the two groups were compared,and the occurrence of postoperative complications in the two groups were observed.Results:The amount of intraoperative blood loss in the SSLH group was less than that in the DSLH group,the time to get out of bed and hospital stay were shorter than those in the DSLH group,and the operative time was longer than that in the DSLH group(P<0.05).Cor,NE and ALD in the two groups at 1 d after operation increased,but SSLH group was lower than DSLH group at the same time point(P<0.05).1 d after operation,SP and 5-HT in the two groups increased,but SSLH group was lower than DSLH group at the same time point;β-EP decreased,but SSLH group was higher than DSLH group at the same time point(P<0.05).There was no significant difference between the complication rates in the two groups(P>0.05).Conclusion:Compared with DSLH,SSLH has better efficacy in the treatment of children with inguinal hernia,it can improve clinical indexes,reduce the degree of stress response and the level of pain mediator.

关 键 词：单孔腹腔镜疝修补术 双孔腹腔镜疝修补术 腹股沟疝 疗效 应激反应 疼痛介质 

分 类 号：R656.2[医药卫生—外科学]