摘要
目的:探讨经脐入路三孔腹腔镜实施腹膜前修补术治疗腹股沟疝的临床效果。方法:采用临床随机前瞻性研究方法,选取2021年3月—2024年6月在北京市仁和医院行手术治疗的189例腹股沟疝患者,根据随机数字表将其分为A组(n=95)和B组(n=94)。A组经脐入路三孔腹腔镜实施腹膜前修补术,B组采用传统无张力疝修补术。对比两组的围手术期指标、炎症因子、疼痛程度、疼痛介质水平及并发症发生率。结果:A组手术时间、住院时间短于B组,肛门排气时间、术后恢复正常活动时间均早于B组,术中出血量少于B组(P<0.05);术后24 h,两组TNF-α、IL-6、IL-1β水平较术前升高,且B组均高于A组(P<0.05);术后4、8、12、24 h,A组VAS评分低于B组(P<0.05);术后24 h,两组β-内啡肽(β-EP)、5-羟色胺(5-HT)、P物质水平比术前高,但A组均低于B组(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:经脐入路三孔腹腔镜实施腹膜前修补术治疗腹股沟疝较传统无张力疝修补术具有手术创伤小、疼痛程度轻、炎症反应程度轻等优势。
Objective:To investigate the clinical effect of transumbilical approach three-port laparoscopic in preperitoneal repair surgery for inguinal hernia.Method:A clinical randomized prospective study was conducted.A total of 189 patients with inguinal hernia who underwent surgical treatment at Beijing Renhe Hospital from March 2021 to June 2024 were selected and divided into group A(n=95)and group B(n=94)according to the random number table.Group A underwent transumbilical approach three-port laparoscopic in preperitoneal repair surgery for inguinal hernia,while group B received traditional tension-free hernia repair surgery.The perioperative indicators,inflammatory factors,pain degree,levels of pain mediators and incidence of complications of the two groups were compared.Result:The surgery time,hospital stay in group A were shorter than those in group B,anal exhaust time and postoperative recovery to normal activities were all earlier than those in group B,and the intraoperative blood loss was less than that in group B(P<0.05).At 24 hours after the surgery,the levels of TNF-α,IL-6 and IL-1βin both groups increased compared with those before the surgery,and those in group B were all higher than those in group A(P<0.05).At 4,8,12 and 24 hours after the surgery,the VAS scores of group A were lower than those of group B(P<0.05).At 24 hours after the surgery,the levels ofβ-endorphin(β-EP),serotonin(5-HT),substance P in both groups increased compared with those before the surgery,and those in group A were all lower than those in group B(P<0.05).There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:Compared with traditional tension-free hernia repair surgery,transumbilical approach three-port laparoscopic in preperitoneal repair surgery for inguinal hernia has the advantages of less trauma,less pain and less inflammation.
作者
赵永健
涂春明
董庆申
ZHAO Yongjian;TU Chunming;DONG Qingshen(Department of General SurgeryⅡ,Beijing Renhe Hospital,Beijing 102600,China;不详)
出处
《中国医学创新》
2025年第28期42-47,共6页
Medical Innovation of China
关键词
经脐入路
三孔腹腔镜
腹膜前修补术
腹股沟疝
疼痛
炎症反应
Transumbilical approach
Three-port laparoscopic
Preperitoneal repair surgery
Inguinal hernia
Pain
Inflammatory response
