摘要
目的探讨无张力疝修补术(Lichtenstein)、完全腹膜外疝修补术(TEP)及腹腔镜腹膜前疝修补术(TAPP)对成人腹股沟疝患者术后视觉模拟疼痛(VAS)及C反应蛋白(CRP)、白介素-6(IL-6)及肿瘤坏死因子(TNF-α)的影响。方法选取2018年1月至2020年12月于北京市平谷区医院进行治疗的158例成人腹股沟疝患者临床资料,依据手术方式不同分为A组(TEP)51例、B组(TAAP)53例及C组(Lichtenstein)54例。分析三组手术状况、住院时间及并发症发生率;比较术后即刻、术后24 h、术后7 d、术后1个月及术后3个月患者VAS评分;比较术前与术后7 d患者CRP、IL-6及TNF-α变化。结果A组、B组手术时间长于C组,术中出血量及住院时间均少于C组,术后即刻、术后24 h、术后7 d、术后1个月及术后3个月VAS评分均低于C组,术后7 d,CRP、IL-6及TNF-α水平均低于C组,差异均有统计学意义(P<0.05),但A组与B组间手术时间、术中出血量、住院时间、VAS评分、CRP、IL-6及TNF-α比较,差异无统计学意义(P>0.05)。三组并发症发生率分别为9.80%、5.66%及16.67%,三组比较差异无统计学意义(P>0.05)。结论较Lichtenstein术,腹腔镜下TEP、TAPP治疗能更有效降低患者术后VAS评分,促进CRP、IL-6及TNF-α水平下降,可在临床推广应用。
Objective To investigate the effects of tension-free herniorrhaphy(Lichtenstein),totally extraperitoneal(TEP)hernia repair and transabdominal preperitoneal(TAPP)repair on postoperative Visu-al Analog Scale(VAS)score,C-reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factor(TNF-α)in adults with inguinal hernia.Methods The clinical data of 158 adults with inguinal hernia who were treated in Pinggu District Hospital,Beijing from January 2018 to December 2020 were collected.According to different surgical methods,the subjects were divided into group A(51 patients treated with TEP hernia repair),group B(53 patients treated with TAPP repair)and group C(54 patients treated with Lichtenstein).Surgical conditions,hospital stay and the incidence of complications in the three groups were analyzed.The VAS scores immediately after operation,at 24 h after operation,on the 7^(th)day after operation,and at 1 month and 3 months after operation were compared.The changes in CRP,IL-6 and TNF-αbefore operation and on the 7^(th)day after operation were compared.Results The operation time of group A and group B was longer than that of group C.The intraoperative blood loss and hospital stay were less/shorter than those of group C.The VAS scores immediately after operation,at 24 h after operation,on the 7^(th)day after operation,and at 1 month and 3 months after operation were lower than those of group C.On the 7^(th)day after operation,the levels of CRP,IL-6 and TNF-αwere lower than those in group C(P<0.05).The above-mentioned indicators showed no statistically significant difference between group A and group B(P>0.05).The incidence rates of complications in the three groups were 9.80%,5.66%and 16.67%,without statistically significant difference among the groups(P>0.05).Conclusion Compared with Lichtenstein operation,laparoscopic TEP and TAPP can reduce postoperative VAS score of adults with inguinal hernia more effectively,and help lower the levels of CRP,IL-6 and TNF-α.
作者
田国标
陈晓波
朱江
张建国
狄长安
TIAN Guobiao;CHEN Xiaobo;ZHU Jiang;ZHANG Jianguo;DI Changan(Department of General Surgery,Pinggu District Hospital,Beijing,China,101200)
出处
《分子诊断与治疗杂志》
2023年第12期2194-2197,共4页
Journal of Molecular Diagnostics and Therapy
基金
平谷区科技攻关计划项目(201907332)。
