腹腔镜完全腹膜外疝修补术对老年腹股沟疝患者呼吸功能、促胃动素的影响  

Effect of laparoscopic complete peritoneal hernia repair on respiratory function and motilin in elderly patients with inguinal hernia

作　　者：汪峰 谢俊华 何中文 Wang Feng;Xie Junhua;He Zhongwen(Department of Gastrointestinal and Hernia Surgery,Chongqing Fengdu People's Hospital,Chongqing 408200,China)

机构地区：[1]重庆市丰都人民医院胃肠疝外科,重庆408200

出　　处：《中国医师进修杂志》2023年第12期1112-1116,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨腹腔镜完全腹膜外疝修补术(TEP)对老年腹股沟疝患者呼吸功能、促胃动素(MOL)的影响。方法选择2020年1月至2021年12月重庆市丰都人民医院收治的老年腹股沟疝患者120例,其中60例患者行腹腔镜经腹腹膜前疝修补术(TAPP,对照组),60例患者行TEP(研究组),比较两组手术指标、术后不同时点视觉模拟量表(VAS)评分、呼吸功能指标、胃泌素(GAS)、MOL水平以及术后并发症发生情况。结果研究组手术时间长于对照组[(66.36±10.05)min比(53.69±8.59)min],恢复正常活动时间短于对照组[(4.09±0.59)d比(5.15±1.06)d],术后1、3、7 d VAS评分均低于对照组[(4.49±1.26)分比(5.46±1.48)分、(3.65±0.58)分比(4.52±0.95)分、(2.42±0.41)分比(3.54±0.48)分],差异均有统计学意义(P<0.05)。研究组建立气腹10、30、90 min时呼气末二氧化碳分压(PETCO_(2))、气道压力(Paw)高于对照组[(40.66±4.52)mmHg(1 mmHg=0.133 kPa)比(37.48±5.26)mmHg、(19.88±1.63)cmH_(2)O(1 cmH_(2)O=0.098 kPa)比(16.59±2.15)cmH_(2)O;(44.65±4.18)mmHg比(41.58±4.58)mmHg、(20.49±1.65)cmH_(2)O比(16.95±2.84)cmH_(2)O;(50.16±3.54)mmHg比(45.59±4.65)mmHg、(21.69±1.78)cmH_(2)O比(17.49±2.15)cmH_(2)O],差异有统计学意义(P<0.05)。研究组术后3 d MOL、GAS水平高于对照组[(396.54±13.58)ng/L比(332.52±16.95)ng/L、(118.95±8.95)ng/L比(102.58±10.65)ng/L],差异有统计学意义(P<0.05)。两组并发症发生率比较差异无统计学意义(P>0.05)。结论TEP和TAPP治疗老年腹股沟疝均有一定治疗效果,TEP术后恢复时间更短,疼痛程度更轻,对肠胃功能影响较小,但会对呼吸功能产生一定影响。Objective To investigate the effects of laparoscopic total extraperitoneal hernia repair(TEP)on respiratory function and motilin(MOL)in elderly patients with inguinal hernia.Methods One hundred and twenty elderly patients with inguinal hernia admitted in Chongqing Fengdu People's Hospital from January 2020 to December 2021 were divided into two groups according to the method of operation,60 patients who performed laparoscopic preperitoneal hernia repair(TAPP)was enrolled in control group,and 60 patients who performed TEP was enrolled in the study group.The operation index,visual analogue scale(VAS)scores at different time,respiratory function index and gastrin(GAS),MOL levels and postoperative complications were compared between the two groups.Results Compared with the control group,the operation time in the study group was longer,the recovery time was shorter and the VAS scores were lower on the 1st,3rd and 7th day after operation:(66.36±10.05)min vs.(53.69±8.59)min,(4.09±0.59)d vs.(5.15±1.06)d,(4.49±1.26)scores vs.(5.46±1.48)scores,(3.65±0.58)scores vs.(4.52±0.95)scores,(2.42±0.41)scores vs.(3.54±0.48)scores,there were statistical differences(P<0.05).The levels of end-expiratory carbon dioxide pressure(PETCO2)and airway pressure(Paw)in the study group at 10,30 and 90 min postoperatively were higher than those in the control group:(40.66±4.52)mmHg(1 mmHg=0.133 kPa)vs.(37.48±5.26)mmHg,(19.88±1.63)cmH2O(1 cmH2O=0.098 kPa)vs.(16.59±2.15)cmH2O;(44.65±4.18)mmHg vs.(41.58±4.58)mmHg,(20.49±1.65)cmH2O vs.(16.95±2.84)cmH2O;(50.16±3.54)mmHg vs.(45.59±4.65)mmHg,(21.69±1.78)cmH2O vs.(17.49±2.15)cmH2O,there were statistical differences(P<0.05).The levels of MOL and GAS in the study group at 3 d postoperatively were higher than those in the control group:(396.54±13.58)ng/L vs.(332.52±16.95)ng/L,(118.95±8.95)ng/L vs.(102.58±10.65)ng/L,there were statistical differences(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusions Both TEP and

关 键 词：疝 腹股沟 疝修补术 老年人 促胃动素 呼吸功能 

分 类 号：R656.21[医药卫生—外科学]