摘要
目的分析腹腔镜经腹腹膜前疝修补术(TAPP)与疝环充填式无张力修补术治疗腹股沟疝患者的疗效及经济学效益。方法2017年1月至2021年2月宿州市第一人民医院普外科收治的腹股沟疝患者100例,采用随机数字表法分为对照组与试验组,各50例。对照组行疝环充填式无张力修补术,试验组行TAPP术,2组均随访至出院。分析2组围手术期指标、不同时间点疼痛程度及生活质量,术前、术后1 d炎症反应及氧化应激指标,住院期间并发症发生情况,经济学效益(住院时间、住院费用)。结果组间比较试验组术中出血量更少,手术、术后下床活动、术后胃肠功能恢复以及术后恢复正常活动时间更短(P<0.05)。术后6 h、24 h、48 h,2组疼痛视觉模拟评分量表(VAS)得分呈降低趋势,但试验组更低(P<0.05);2组简易健康调查简表36(SF-36)得分呈升高趋势,但试验组更高(P<0.05)。术后1 d 2组血清肿瘤坏死因子-α、C反应蛋白、白介素-6、丙二醛水平较术前升高,但试验组更低(P<0.05);术后1 d 2组血清超氧化物歧化酶水平较术前降低,但试验组更高(P<0.05)。术后住院期间试验组并发症发生率较对照组更低(8.00%vs34.00%,P<0.05)。试验组住院时间短于对照组,住院费用高于对照组(P<0.05)。结论相较疝环充填式无张力修补术,TAPP术治疗腹股沟疝可降低患者手术创伤,促进术后康复,缓解疼痛并改善患者生活质量,分析与其降低机体炎症反应及氧化应激有关,但住院费用更高,临床可考虑患者病情及经济情况选择治疗方式。
Objective To analyze the efficacy and economic benefit of laparoscopic transabdominal preperitoneal prosthesis(TAPP)and hernia ring filling tension-free repair in the treatment of patients with inguinal hernias.Methods From January 2017 to February 2021,100 patients with inguinal hernias who were admitted to the General Surgery Department of Suzhou First People's Hospital were divided into the control group and the research group,with 50 cases in each group.The method used was the random number table method.The control group received hernia ring filling for tension-free repair,and the research group received TAPP.Both groups were followed up until discharge.The perioperative indicators,pain and quality of life at different time points,inflammatory response and oxidative stress indicators before and 1 d after surgery,the incidence of complications during hospitalization,and economic benefits(hospitalization time,hospitalization costs)were compared between the two groups.Results The intraoperative blood loss in the research group was lower in the two groups,and the time of surgery,postoperative ambulation,postoperative gastrointestinal function recovery,and postoperative return to normal activities was shorter in the two groups(P<0.05).At 6 h,24 h,and 48 h after surgery,the scores of visual analog scale(VAS)of the two groups showed a decreasing trend,and the research group was lower in the two groups(P<0.05),the scores of short form36(SF-36)showed an increasing trend,and the research group was higher between the two group(P<0.05).1 d after surgery,the serum levels of tumor necrosis factorα(TNF-α),C-reactive protein(CPR),interleukin-6(IL-6)and malondialdehyde(MDA)in the two groups were higher than those before surgery,but the research group was lower in the two groups(P<0.05);the serum level of superoxide dismutase(SOD)in the two groups were lower than those before surgery,but the research group was higher in the two groups(P<0.05).The incidence of complications in the research group during hospitalization was low
作者
任伙明
苏舒
张健
范彬
Huoming Ren;Shu Su;Jian Zhang;Bin Fan(First Department of General Surgery,Suzhou First People's Hospital,Suzhou 234000,Anhui Province,China)
出处
《中华疝和腹壁外科杂志（电子版）》
2022年第6期682-686,共5页
Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)
基金
2021年度安徽省卫生健康委科研项目立项项目(AHWJ2021a033)
关键词
疝
腹股沟
腹腔镜
疝修补术
疼痛
炎症反应
氧化应激
经济
Hernia
inguinal
Laparoscopy
Herniorrhaphy
Pain
Inflammatory response
Oxidative stress
Economy
