腹腔镜下疝修补术对嵌顿性腹股沟疝患者康复指标、肠黏膜屏障功能、复发的影响  

The Impact of Laparoscopic Hernia Repair on Rehabilitation Indicators,Intestinal Mucosal Barrier Function and Recurrence in Patients with Incarcerated Inguinal Hernia

作　　者：侯晓翔 于建全 HOU Xiaoxiang;YU Jianquan(General Surgery Department,Shouguang Hospital of Traditional Chinese Medicine,Shouguang 262700,China;不详)

机构地区：[1]寿光市中医医院普外科,山东寿光262700

出　　处：《中国医学创新》2025年第8期39-43,共5页Medical Innovation of China

摘　　要：目的:探究腹腔镜经腹腔的腹膜前修补(TAPP)对嵌顿性腹股沟疝患者康复指标、肠黏膜屏障功能、复发的影响。方法:回顾性收集2021年9月—2024年2月寿光市中医医院急诊嵌顿性腹股沟疝患者100例的临床资料,其中50例采取TAPP(TAPP组),50例采取开放无张力疝修补术(对照组)。比较两组手术时间、术中出血量、尿管拔除时间、下床活动时间、疼痛持续时间、术后24 h视觉模拟评分法(VAS)评分、住院时间、炎症因子[肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白细胞介素-6(IL-6)]、肠黏膜屏障功能[二胺氧化酶(DAO)、D-乳酸(D-LAC)]、并发症发生率及复发率。结果:TAPP组尿管拔除时间、下床活动时间均早于对照组,住院时间、疼痛持续时间均较对照组短,术后24 h VAS评分较对照组低,差异均有统计学意义(P<0.05);与术前相比,两组术后24 h的血清TNF-α、IL-6、CRP水平均升高,但TAPP组均低于对照组,差异均有统计学意义(P<0.05);与术前相比,两组术后24 h的血清DAO、D-LAC水平均下降,且TAPP组均低于对照组,差异均有统计学意义(P<0.05);两组并发症发生率、复发率差异均无统计学意义(P>0.05)。结论:TAPP较开放式手术治疗嵌顿性腹股沟疝能优化康复指标,减轻机体应激反应,改善肠屏障功能。Objective:To explore the effect of laparoscopic transabdominal preperitoneal approach(TAPP)on the rehabilitation index,intestinal mucosal barrier function and recurrence of incarcerated inguinal hernia.Method:The clinical data of 100 patients with incarcerated inguinal hernia in Shouguang Hospital of Traditional Chinese Medicine from September 2021 to February 2024 were retrospectively collected,of which 50 patients were treated with TAPP(TAPP group)and 50 patients were treated with open tension-free hernia repair(control group).The operation time,intraoperative blood loss,catheter removal time,ambulation time,pain duration,visual analogue scale(VAS)scores at 24 hours after operation,hospital stay,inflammatory factors[tumor necrosis factor-α(TNF-α),C reactive protein(CRP),interleukin-6(IL-6)],intestinal mucosal barrier function[diamine oxidase(DAO),D-lactic acid(D-LAC)],complication rate and recurrence rate were compared between the two groups.Result:The time of urinary tube extraction and the time of getting out of bed in TAPP group were earlier than those in control group,the hospital stay and pain duration were shorter than those in control group,and the VAS score at 24 h after surgery was lower than that in control group,the differences were statistically significant(P<0.05).Compared with before surgery,serum TNF-α,IL-6 and CRP levels in two groups were increased 24 h after surgery,but TAPP group were lower than those of control group,the differences were statistically significant(P<0.05).Compared with before surgery,the serum DAO and D-LAC levels of both groups decreased 24 h after surgery,and the TAPP group were lower than those of the control group,the differences were statistically significant(P<0.05).There were no significant differences in complication rate and recurrence rate between the two groups(P>0.05).Conclusion:TAPP can optimize rehabilitation indicators,reduce stress responses,and improve intestinal barrier function compared to open surgical treatment for incarcerated inguinal hernia.

关 键 词：嵌顿性腹股沟疝 经腹腔的腹膜前修补 肠黏膜屏障功能 复发 

分 类 号：R65[医药卫生—外科学]