腹腔镜TAPP与平片式无张力疝修补术治疗腹股沟疝患者的临床效果  

Clinical Effect of Laparoscopic TAPP and Flat Tablet Tension-free Hernia Repair in the Treatment of Patients with Inguinal Hernia

作　　者：吴晨 余涛 林春冬 WU Chen;YU Tao;LIN Chundong(Fuzhou Jin’an District Hospital,Fuzhou 350011,China;不详)

机构地区：[1]福州市晋安区医院,福州福建350011 [2]厦门大学附属第一医院杏林分院

出　　处：《中外医学研究》2024年第23期118-122,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：厦门大学启航基金项目(2021QH1024)。

摘　　要：目的:探讨腹腔镜经腹腹膜前疝修补术(TAPP)与平片式无张力疝修补术治疗腹股沟疝患者的临床效果。方法:选择2022年8月—2023年8月福州市晋安区医院收治的97例腹股沟疝患者作为研究对象,根据随机数表法将患者分为传统组(平片式无张力疝修补术,n=48)和腔镜组(腹腔镜TAPP,n=49)。比较两组临床指标、疼痛程度、股静脉血流状态、炎症因子、氧化应激反应及并发症。结果:腔镜组手术时间、术后肛门排气时间、术后下床时间及出院时间短于传统组,术中出血量少于传统组,差异有统计学意义(P<0.05);术后24 h、48 h、72 h,两组视觉模拟评分法(VAS)评分低于术前,且腔镜组低于传统组,差异有统计学意义(P<0.05);术后48 h,两组血流速度及血流量低于术前,腔镜组血流速度快于传统组,血流量高于传统组,差异有统计学意义(P<0.05);术后48 h,两组白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、白细胞介素-4(IL-4)低于术前,且腔镜组低于传统组,差异有统计学意义(P<0.05)。腔镜组并发症发生率为6.12%,低于传统组的20.83%,差异有统计学意义(P<0.05)。结论:腹腔镜TAPP能改善腹股沟疝患者股静脉血流,调节血清炎症因子水平,同时可减轻术后疼痛,缩短住院时间,减少并发症发生。Objective:To investigate the effect of laparoscopic transabdominal preperitoneal prosthesis(TAPP)and flat plate tension-free hernia repair in the treatment of patients with inguinal hernia.Method:A total of 97 patients with inguinal hernia who admitted to Fuzhou Jin’an District Hospital from August 2022 to August 2023 were selected as the study objects,the patients were divided into the traditional group(flat plate tension-free hernia repair,n=48)and the laparoscopic group(laparoscopic TAPP,n=49)according to the random number table method.The clinical indicators,pain degree,femoral vein blood flow status,inflammatory factors,oxidative stress response and complications were compared between two groups.Result:The operation time,postoperative anal exhaust time,postoperative ambulation time and discharge time of the laparoscopic group were shorter than those of the traditional group,and the intraoperative blood loss was less than that of the traditional group,the differences were statistically significant(P<0.05);at 24 h,48 h and 72 h after operation,the visual analogue scale(VAS)scores of two groups were lower than those before operation,and those in the laparoscopic group were lower than those in the traditional group,the differences were statistically significant(P<0.05);at 48 h after operation,the blood flow velocity and blood flow volume of two groups were lower than those before operation,the blood flow velocity of the laparoscopic group was faster than that of the traditional group,and the blood flow volume was higher than that of the traditional group,the differences were statistically significant(P<0.05);at 48 h after operation,the levels of interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP)and interleukin-4(IL-4)in two groups were lower than those before operation,and those in the laparoscopic group were lower than those in the traditional group,the differences were statistically significant(P<0.05).The incidence of complications in the laparoscopic group was 6.12%,which was lower than 20.83%

关 键 词：腹腔镜经腹腹膜前疝修补术 平片式无张力疝修补 腹股沟疝 股静脉 

分 类 号：R656.21[医药卫生—外科学]