TAPP与传统腹股沟疝无张力修补术对成人腹股沟疝手术应激及疼痛影响的对比研究

doi:10.3969/j.issn.1671-7171.2021.04.007

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摘要 【目的】 对比经腹腹膜前腹腔镜疝修补术(TAPP)与传统腹股沟疝无张力修补术对成人腹股沟疝手术应激及疼痛的影响。【方法】 选取本院2016年1月至2020年1月收治的74例成人腹股沟疝患者,根据手术时间分为对照组(2016年1月至2018年1月,37例)和TAPP组(2018年2月至2020年1月,37例)。对照组接受传统腹股沟疝无张力修补术,TAPP组接受TAPP。对比两组手术指标、并发症、疼痛评分(VAS评分)、应激指标及炎症指标。【结果】 TAPP组手术时间、术后下床时间、术后住院时间、胃肠功能恢复时间均短于对照组(均P<0.05),术中出血量低于对照组(P<0.05),住院费用高于对照组(P<0.05)。TAPP组皮瓣感染或坏死率(0.00%)及总并发症发生率(10.81%)低于对照组(0.00%、35.14%,均P<0.05)。TAPP组术后6 h、24 h、3 d 的VAS评分均低于对照组(均P<0.05)。治疗后1 d两组丙二醛(MDA)、白细胞介素6(IL-6)均较治疗前增高(均P<0.05),SOD较治疗前降低(均P<0.05),TAPP组MDA、IL-6低于对照组(均P<0.05),SOD高于对照组(P<0.05)。【结论】 与传统腹股沟疝无张力修补术相比,TAPP安全性高、术后恢复快,对应激反应及炎症反应的影响较小,值得临床推广应用。

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	王伟
	赵宇斌

关键词 ：疝,腹股沟/外科学, 腹腔镜检查, 应激,生理学, 疼痛, 手术后

Abstract：【Objective】 To compare the effects of laparoscopic transabdominal preperitoneal prosthesis (TAPP) and traditional inguinal hernia tension-free repair on stress and pain in adult inguinal hernia. 【Methods】 Seventy-four adult patients with inguinal hernia admitted to Our hospital from January 2016 to January 2020 were selected and divided into a control group (January 2016 to January 2018, 37 cases) and TAPP group(From February 2018 to January 2020, 37 cases) according to the operation time . The control group received traditional tension-free inguinal hernia repair, and the TAPP group received TAPP. The operation indexes, complications, pain scores (VAS scores), stress indexes and inflammation indexes were compared between the two groups. 【Results】 The operation time, postoperative bed time, postoperative hospital stay, and gastrointestinal function recovery time of the TAPP group were shorter than those of the control group (all P<0.05), and the intraoperative blood loss was lower than that of the control group (P<0.05), but the cost was higher than the control group (P<0.05). The flap infection or necrosis rate (0.00%) and total complication rate (10.81%) in the TAPP group were lower than those in the control group (0.00%, 35.14%, all P<0.05). The VAS scores of the TAPP group at 6h, 24h and 3 days after operation were lower than those of the control group (all P<0.05). One day after treatment, the MDA, CRP, and PCT in both groups were higher than before treatment (all P<0.05), and SOD was lower than before treatment (all P<0.05). The MDA, CRP, and PCT in the TAPP group were lower than those in the control group (all P<0.05), SOD was higher than the control group (P<0.05). 【Conclusion】 Compared with the traditional tension-free inguinal hernia repair, TAPP has higher safety and quicker postoperative recovery, and has less impact on stress and inflammation.

Key words： Hernia,Inguinal /SU Laparoscopy Stress,Physiological Pain,Postoperative

收稿日期: 2020-11-24

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R656.21

通讯作者: * E-mail:2690223005@qq.com

引用本文:

王伟, 赵宇斌. TAPP与传统腹股沟疝无张力修补术对成人腹股沟疝手术应激及疼痛影响的对比研究[J]. 医学临床研究, 2021, 38(4): 504-507.
WANG Wei, ZHAO Yu-bin. Comparative Study of TAPP and Traditional Inguinal Hernia Tension-free Repair on Stress and Pain in Adult Inguinal Hernia. JOURNAL OF CLINICAL RESEARCH, 2021, 38(4): 504-507.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2021.04.007 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2021/V38/I4/504