经腹膜前疝修补术与平片式无张力疝修补术治疗腹股沟疝患者的临床疗效  

Clinical effects of transabdominal preperitoneal prosthesis and lichtenstein tension-free hernia repair in the treatment of patients with inguinal hernia

作　　者：张华 涂燕萍 李志斌 ZHANG Hua;TU Yanping;LI Zhibin(Department One of Surgery,Gongqingcheng People's Hospital,Jiujiang,Jiangxi,332020,China;Department of Anesthesiology,Gongqingcheng People's Hospital,Jiujiang,Jiangxi,332020,China;Department of General Surgery,Gongqing City People's Hospital,Jiujiang,Jiangxi,332020,China)

机构地区：[1]共青城市人民医院外一科,江西九江332020 [2]共青城市人民医院麻醉科,江西九江332020 [3]共青城市人民医院普外科,江西九江332020

出　　处：《当代医学》2024年第6期23-27,共5页Contemporary Medicine

摘　　要：目的分析经腹膜前疝修补术(TAPP)与平片式无张力疝修补术治疗腹股沟疝患者的临床疗效。方法选取2019年1月至2021年1月共青城市人民医院收治的75例腹股沟疝患者作为研究对象,按照自愿原则选择手术方式分为A组(n=36)与B组(n=39)。A组行TAPP,B组行平片式无张力疝修补术。比较两组手术指标、炎症因子[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]、股静脉血流状态参数(血流量、血流速度)、睾丸血流动力学参数[舒张末期血流速度(EDV)、收缩期峰值血流速度(PSV)、患侧睾丸动脉最大血流速度(Vmax)]、术后并发症发生率及1年内复发率。结果两组术后肛门排气时间比较差异无统计学意义;A组术中出血量少于B组,首次下床时间及住院时间均短于B组,差异有统计学意义(P<0.05);术后,两组hs-CRP、TNF-α、IL-6水平均高于术前,但A组低于B组,差异有统计学意义(P<0.05);术后,两组血流量大于术前,血流速度快于术前,且A组血流量大于B组,血流速度快于B组,差异有统计学意义(P<0.05);术后,两组EDV、PSV均快于术前,Vmax慢于术前,且A组EDV、PSV、Vmax均慢于B组,差异有统计学意义(P<0.05);术后1、14d及1、3个月A组VAS评分均低于B组,差异有统计学意义(P<0.05);两组并发症发生率及复发率比较差异无统计学意义。结论TAPP可减少术中出血量、首次下床时间及住院时间,降低炎症反应,加大股静脉血流量及加快血流速度,降低疼痛感,平片式无张力疝修补术对男性生殖功能影响更小,两者各有利弊。Objective To analyze the clinical effects of transabdominal preperitoneal prosthesis(TAPP)and lichtenstein tension-free hernia repair in the treatment of patients with inguinal hernia.Methods 75 patients with inguinal hernia who were admitted to Gongqingcheng People's Hos-pital from January 2019 to January 2021 were selected as the research subjects,they were divided into the group A(n=36)and the group B(n=39)ac-cording to surgical method.The group A underwent TAPP,the group B underwent lichtenstein tension-free hernia repair.The surgical indicators,in-flammatory factors(hypersensitive C-reactive protein[hs-CRP],tumor necrosis factor-α[TNF-α],interleukin-6[IL-6]),femoral vein blood flow pa-rameters(blood flow volume and velocity of femoral vein),testicular hemodynamic parameters(end diastolic blood flow velocity[EDV],peak systol-ic blood flow velocity[PSV]and maximum velocity[Vmax]),postoperative complications and 1-year recurrence rate were compared between the two groups.Results There was no statistically significant difference in postoperative anal exhaust time between the two groups;the intraoperative blood loss in the group A was less than that in the group B,the time of first ambulation and hospital stay were shorter than those in the group B,the differ-ences were statistically significant(P<0.05);after surgery,the levels of hs-CRP,TNF-αand IL-6 of the two groups were higher than before surgery,and the group A was lower than the group B,the differences were statistically significant(P<0.05);after surgery,the blood flow volume of the two groups was higher than before surgery,blood flow velocity was faster than before surgery,and the blood flow volume in the group A was higher than that in the group B,blood flow velocity in the group A was faster than that in the group B,the differences were statistically significant(P<0.05);af-ter surgery,the EDV and PSV of the two groups were faster than before surgery,Vmax was slower than before surgery,and the EDV,PSV and Vmax in the group A were slower than those in t

关 键 词：腹股沟疝 腹腔镜经腹膜前疝修补术 平片式无张力疝修补术 

分 类 号：R656.21[医药卫生—外科学]