首页|全腹膜外疝修补术及微创无张力疝修补术治疗成人腹股沟疝的效果

全腹膜外疝修补术及微创无张力疝修补术治疗成人腹股沟疝的效果

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目的:观察全腹膜外疝修补术(total extraperitoneal herniorrhaphy,TEP)及微创无张力疝修补术治疗成人腹股沟疝的效果。方法:选取 2020 年 1 月—2022 年 12 月宜兴市人民医院普外科收治的 280 例腹股沟疝患者作为研究对象。根据随机数表法将其分为观察组和对照组,各 140 例。对照组实施微创无张力疝修补术(Lichtenstein)治疗,观察组实施TEP治疗。比较两组围手术期指标,入院当日、出院前 1 d胃肠功能、应激指标、疼痛程度、生活质量。结果:观察组首次肛门排气时间、下床时间均早于对照组,住院时间短于对照组,差异有统计学意义(P<0。05)。出院前 1 d,两组胃动素(motilin,MTL)水平升高,胃蛋白酶原(pepsinogen,PG)水平降低,观察组MTL水平高于对照组,PG水平低于对照组,差异有统计学意义(P<0。05)。出院前 1 d,两组肾上腺皮质激素(adrenal cortex hormone,ACH)、去甲肾上腺素(norepinephrine,NE)、皮质醇(cortisol,Cor)水平均降低,观察组ACH、NE、Cor水平均低于对照组,差异有统计学意义(P<0。05)。出院前 1 d,两组面部表情、肢体活动、治疗适应性评分均降低,观察组面部表情、肢体活动、治疗适应性评分均低于对照组,差异有统计学意义(P<0。05)。出院前 1 d,两组生理功能、心理功能、社会功能评分均升高,观察组生理功能、心理功能、社会功能评分均高于对照组,差异有统计学意义(P<0。05)。结论:TEP治疗能够有效降低成人腹股沟疝患者激素水平,改善胃肠功能。
Effect of Total Extraperitoneal Hernia Repair Surgery and Minimally Invasive Tension-free Hernia Repair Surgery in the Treatment of Adult Inguinal Hernia
Objective:To observe the effect of total extraperitoneal hernia repair surgery(TEP)and minimally invasive tension-free hernia repair surgery in the treatment of adult inguinal hernia.Method:A total of 280 patients with inguinal hernia admitted to the General Surgery Department of Yixing People's Hospital from January 2020 to December 2022 were selected as the study objects.They were divided into observation group and control group according to random number table method,140 cases in each group.The control group was treated with minimally invasive tension-free hernia repair surgery(Lichtenstein),and the observation group was treated with TEP.Perioperative indexes,gastrointestinal function,stress index,pain degree and quality of life on the day of admission and 1 d before discharge were compared between the two groups.Result:The time of first anal exhaust and getting out of bed in the observation group were earlier than those in the control group,and the time of hospitalization was shorter than that in the control group,the differences were statistically significant(P<0.05).At 1 d before discharge,the levels of motilin(MTL)increased and pepsinogen(PG)decreased in both groups,the MTL level in the observation group was higher than that in the control group,while the PG level was lower than that in the control group,and the differences were statistically significant(P<0.05).At 1 d before discharge,the levels of adrenal cortex hormone(ACH),norepinephrine(NE),cortisol(Cor)in both groups were decreased,and the levels of ACH,NE and Cor in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).At 1 d before discharge,the facial expression,body activity and treatment adaptability scores of both groups were decreased,and the facial expression,body activity and treatment adaptability scores of the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).At 1 d before discharge,the scores of physiological function,psychological function and social function of both groups were increased,and the scores of physiological function,psychological function and social function of the observation group were higher than those of the control group,the differences were statistically significant(P<0.05).Conclusion:TEP can effectively reduce hormone levels and improve gastrointestinal function in adults with inguinal hernia.

Total extraperitoneal hernia repair surgeryMinimally invasive tension-free hernia repair surgeryAdult inguinal herniaGastrointestinal function

吴思远、陈翔

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宜兴市人民医院 江苏 宜兴 214200

全腹膜外疝修补术 微创无张力疝修补术 成人腹股沟疝 胃肠功能

2024

中外医学研究
中国医院管理杂志社

中外医学研究

影响因子:1.149
ISSN:1674-6805
年,卷(期):2024.22(5)
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