平片式与腹膜前间隙无张力疝修补术治疗腹股沟疝对患者术后疼痛程度及近远期复发率的影响  

Influence of plain film and preperitoneal space tensionfree hernia repair on postoperative pain degree and shortterm and long-term recurrence rates in patients with inguinal hernia

作　　者：罗凡昌 卢运 张文韬 LUO Fanchang;LU Yun;ZHANG Wentao(Department of General Surgery,the Third People's Hospital of Jingzhou,Jingzhou,Hubei,434300,China)

机构地区：[1]荆州市第三人民医院普外科,湖北荆州434300

出　　处：《当代医学》2023年第33期17-20,共4页Contemporary Medicine

摘　　要：目的探究平片式与腹膜前间隙无张力疝修补术治疗腹股沟疝对患者术后疼痛程度及近远期复发率的影响。方法选取2018年6月至2020年9月于荆州市第三人民医院行腹股沟疝修补术的128例腹股沟疝患者作为研究对象,根据患者手术意愿分为A组与B组,每组64例。A组行平片式无张力疝修补术,B组行腹膜前间隙无张力疝修补术。比较两组围手术期指标、术后不同时间疼痛程度[视觉模拟评分法(VAS)]、手术前后血清相关因子[基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶抑制剂-2(TIMP-2)、Ⅰ型前胶原羧基端肽/Ⅲ型前胶原羧基端肽(PⅠCP/PⅢNP)]、术后不同时间复发率、术后并发症发生率。结果B组手术时间长于A组,下床行走时间、术后恢复时间、住院时间均短于A组,差异有统计学意义(P<0.05)。术后1 h,两组VAS评分比较差异无统计学意义;术后1、3 d,B组VAS评分均低于A组,差异有统计学意义(P<0.05)。术后3 d,两组MMP-2水平均低于术前,TIMP-2水平及PⅠCP/PⅢNPB均高于术前,且B组MMP-2水平低于A组,TIMP-2水平及PⅠCP/PⅢNPB均高于A组,差异有统计学意义(P<0.05)。术后1、3、6个月,B组复发率均低于A组,差异有统计学意义(P<0.05)。术后3个月,B组并发症发生率低于A组,差异有统计学意义(P<0.05)。结论与平片式无张力疝修补术相比,腹膜前间隙无张力疝修补术治疗腹股沟疝效果显著,能改善患者围手术期指标,减轻患者疼痛感,降低复发率,值得临床推广应用。Objective To investigate the influence of plain film and preperitoneal space tension-free hernia repair on postoperative pain degree and short-term and long-term recurrence rates in patients with inguinal hernia.Methods A total of 128 patients with inguinal hernia who underwent inguinal hernia repair in the Third People's Hospital of Jingzhou from June 2018 to September 2020 were selected as the study subjects,and they were divided into the group A and group B according to their surgical intention,with 64 cases in each group.Group A underwent plain film tensionfree hernia repair,group B underwent preperitoneal space tension-free hernia repair,the perioperative indexes,postoperative pain degree(visual analogue scale[VAS])at different time,serum related factors(matrix metalloproteinase-2[MMP-2],matrix metalloproteinase-inhibitor-2[TIMP-2],typeⅠprocollagen carboxy-terminal peptide/typeⅢprocollagen carboxy-terminal peptide[PⅠCP/PⅢNP])before and after operation,and postoperative recurrent rate at different time and postoperative complication rate were compared between the two groups.Results The operation time in the group B was longer than that in the group A,and the walking time,postoperative recovery time and hospital stay in the group B were shorter than those in the group A,the differences were statistically significant(P<0.05).1 h after operation,there was no significant difference in VAS scores between the two groups;on the 1st and 3rd d after operation,the VAS scores in the group B were lower than those in the group A,and the differences were statistically significant(P<0.05).3 d after operation,the level of MMP-2 of the two groups were lower than before operation,the level of TIMP-2 and PⅠCP/PⅢNPB were higher than before operation,and the level of MMP-2 in the group B was lower than that in the group A,the levels of TIMP-2 and PⅠCP/PⅢNPB were higher than those in the group A,and the differences were statistically significant(P<0.05).At 1,3 and 6 months after operation,the recurrence rate in the

关 键 词：平片式无张力疝修补术 腹膜前间隙无张力疝修补术 腹股沟疝 视觉模拟评分法 

分 类 号：R656.21[医药卫生—外科学]