腹腔镜下经脐入路疝修补术对腹股沟疝患者术后疼痛、血清疼痛介质及炎症指标影响  

Effects of Laparoscopic Transumbilical Hernia Repair on Postoperative Pain,Serum Pain Mediators and Inflammatory Indexes in Patients with In⁃guinal Hernia

作　　者：林飞 王剑 李超 陈爽 燕蜜 LIN Fei;WANG Jian;LI Chao;CHEN Shuang;YAN Mi(Department of General Surgery,The Third People's Hospital of Xiantao City,Xiantao 433000,Hubei,China)

机构地区：[1]湖北省仙桃市第三人民医院普外科,湖北仙桃433000

出　　处：《系统医学》2024年第15期126-129,共4页Systems Medicine

摘　　要：目的 探讨腹腔镜下传统入路与经脐入路疝修补术对腹股沟疝患者术后血清疼痛介质、疼痛与炎症指标的影响。方法 回顾性选取2020年1月-2023年1月湖北省仙桃市第三人民医院收治的66例腹股沟疝患者的临床资料,依据术式将患者分为对照组(行传统腹腔镜经腹腹膜前腹股沟疝修补术)和研究组(行腹腔镜下经脐入路疝修补术),各33例。比较两组术中出血量、手术时间、术后24 h切口疼痛评分、血清疼痛介质、术后并发症、炎症指标。结果 研究组患者术后切口疼痛评分及炎性因子水平低于对照组,差异有统计学意义(P均<0.05)。术后24 h,研究组血清前列腺素E2(2.68±0.24)ng/mL、降钙素基因相关肽(170.46±14.13)ng/mL、P物质(160.12±17.26)ng/L、神经肽Y(140.56±12.43)ng/L水平均低于对照组的(3.56±0.43)ng/mL、(194.88±21.10)ng/mL、(208.43±22.87)ng/L、(168.56±15.43)ng/L,差异有统计学意义(t=10.266、5.483、6.686、8.118,P均<0.05)。两组并发症发生情况对比,差异无统计学意义(P>0.05)。结论 经脐入路疝修补术治疗腹股沟疝,相较于传统手术疼痛较轻,有效降低了炎性反应,临床应用效果相较传统手术有较大优势。Objective To investigate the effects of laparoscopic transumbilical hernia repair on postoperative pain,se-rum pain mediators and inflammatory markers in patients with inguinal hernia.Methods Retrospectively selecting clinical data of sixty-six patients with inguinal hernia admitted to the Third People′s Hospital of Xiantao City,Hubei Province from January 2020 to January 2023,the patients were divided into a control group(undergoing traditional laparoscopic retroperitoneal inguinal hernia repair)and a study group(undergoing laparoscopic umbilical hernia re-pair)based on surgical procedures,with thirty-three cases in each group.Compare the intraoperative bleeding volume,surgical time,24-hour incision pain score,serum pain mediators,postoperative complications,and inflammatory indi-cators between two groups.Results The postoperative incision pain score and inflammatory factor levels in the study group were lower than those in the control group,and the differences were statistically significant(all P<0.05).24 hours after surgery,the levels of serum prostaglandin E2(2.68±0.24)ng/mL,calcitonin gene-related peptide(170.46±14.13)ng/mL,substance P(160.12±17.26)ng/L,and neuropeptide Y(140.56±12.43)ng/L in the study group were all lower than those in the control group(3.56±0.43)ng/mL,(194.88±21.10)ng/mL,(208.43±22.87)ng/L,(168.56±15.43)ng/L,and the differences were statistically significant(t=10.266,5.483,6.686,8.118,all P<0.05).There was no statis-tically significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Transum-bilical hernia repair surgery for inguinal hernia is less painful compared to traditional surgery,effectively reduces in-flammatory reactions,and has significant advantages in clinical application compared to traditional surgery.

关 键 词：腹股沟疝 经脐入路疝修补术 疼痛介质 炎症指标 手术时间 出血量 

分 类 号：R59[医药卫生—内科学]