首页|腹腔镜下经腹腹膜前间隙疝修补术治疗老年嵌顿性腹股沟疝患者的效果

腹腔镜下经腹腹膜前间隙疝修补术治疗老年嵌顿性腹股沟疝患者的效果

扫码查看
目的:观察腹腔镜下经腹腹膜前间隙疝修补术治疗老年嵌顿性腹股沟疝患者的效果.方法:选取 2020 年 1 月至 2022 年12月该院收治的121例老年嵌顿性腹股沟疝患者进行前瞻性研究,根据随机数字表法将其分为对照组60例和观察组61例.对照组采用无张力疝修补术治疗,观察组采用腹腔镜下经腹腹膜前间隙疝修补术治疗,比较两组围手术指标水平、手术前后疼痛程度[视觉模拟评分法(VAS)]评分、创伤应激反应指标[前列腺素E2(PGE2)、促肾上腺皮质激素释放激素(CRH)、促肾上腺皮质激素(ACTH)]水平和术后 1 周并发症发生率.结果:观察组手术时间长于对照组,肛门排气时间和下床活动时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);术后,观察组VAS评分低于对照组,差异有统计学意义(P<0.05);术后,两组PGE2、CRH、ACTH水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05);两组术后并发症发生率比较,差异无统计学意义(P>0.05).结论:腹腔镜下经腹腹膜前间隙疝修补术治疗老年嵌顿性腹股沟疝患者可改善围手术指标水平,降低VAS评分和创伤应激反应指标水平,效果优于无张力疝修补术治疗.
Effects of laparoscopic transabdominal preperitoneal hernia repair in treatment of elderly patients with incarcerated inguinal hernia
Objective:To observe effects of laparoscopic transabdominal preperitoneal hernia repair in treatment of elderly patients with incarcerated inguinal hernia.Methods:A prospective study was conducted on 121 elderly patients with incarcerated inguinal hernia admitted to this hospital from January 2020 to December 2022.According to the random number table method,they were divided into control group(60 cases)and observation group(61 cases).The control group was treated with tension-free hernia repair,while the observation group was treated with laparoscopic transabdominal preperitoneal hernia repair.The perioperative index levels,the pain degree[visual analogue scale(VAS)]score before and after the surgery,the traumatic stress response index[prostaglandin E2(PGE2),corticotropin releasing hormone(CRH),adrenocorticotropic hormone(ACTH)]levels,and the incidence of complications 1 week after the surgery were compared between the two groups.Results:The operation time of the observation group was longer than that of the control group,the anal exhaust time and the out-of-bed time were shorter than those of the control group,the intraoperative blood loss was less than that of the control group,and the differences were statistically significant(P<0.05).After the surgery,the VAS score of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).After the surgery,the levels of PGE2,CRH and ACTH in the two groups were higher than those before the surgery,but those in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusions:Laparoscopic transabdominal preperitoneal hernia repair in the treatment of the elderly patients with incarcerated inguinal hernia can improve the levels of perioperative indexes,reduce the VAS scores and the levels of traumatic stress response indexes.Moreover,it is superior to tension-free hernia repair.

Laparoscopic transabdominal preperitoneal hernia repairTension-free hernia repairElderlyIncarcerated inguinal herniaPainStressComplication

李冰、盛冠楠

展开 >

南阳医学高等专科学校第二附属医院普外科,河南 南阳 473000

腹腔镜下经腹腹膜前间隙疝修补术 无张力疝修补术 老年 嵌顿性腹股沟疝 疼痛 应激 并发症

2024

中国民康医学
中国社会工作协会

中国民康医学

影响因子:0.649
ISSN:1672-0369
年,卷(期):2024.36(4)
  • 10