摘要
目的探讨老年腹股沟疝患者采用腹腔镜全腹膜外疝修补术(laparoscopic total extraperitoneal hernia repair,TEP)治疗的效果。方法选取2021年3月—2022年6月龙岩市第二医院收治的84例老年腹股沟疝患者,按照随机数字表法分成研究组(n=42)与对照组(n=42)。对照组采用无张力疝修补术治疗,研究组采用TEP治疗。对两组围手术期指标、股静脉血流速度、血流量、疼痛程度、应激反应及并发症发生情况进行比较。结果与对照组比较,研究组手术时间、下床时间、住院时间更短(P<0.05),术中出血量更少(P<0.05);术后1 d两组股静脉血流速度、血流量降低(P<0.05),但研究组较对照组更高(P<0.05)。与术后1 d相比,术后3 d两组视觉模拟评分法(visual analogue scale,VAS)评分降低(P<0.05),与对照组相比,研究组术后1 d、3 d评分更低(P<0.05)。术后1 d两组去甲肾上腺素(noradrenaline,NE)、醛固酮(aldosterone,ALD)、皮质醇(cortisol,Cor)水平提高(P<0.05),但研究组水平较对照组更低(P<0.05)。研究组并发症发生率(7.14%)较对照组(23.81%)更低(P<0.05)。结论TEP应用于老年腹股沟疝患者治疗能够减少术中出血量,缩短手术及恢复时间,缓解患者疼痛程度,降低并发症发生率,对股静脉血流速度、血流量及应激反应的影响较小。
Objective To explore the effect of laparoscopic total extraperitoneal hernioplasty(TEP)in elderly patients with inguinal hernia.Methods A total of 84 elderly patients with inguinal hernia admitted to Longyan Second Hospital from March 2021 to June 2022 were randomLy divided into the study group(n=42)and the control group(n=42).The control group was treated with tensionfree hernioplasty,and the study group was treated with TEP.The perioperative indexes,femoral vein blood flow velocity,blood flow,pain degree,stress response and complications of the two groups were compared.Results Compared with the control group,the time of operation,getting out of bed and hospitalization in the study group was shorter(P<0.05),and the amount of bleeding during operation was less(P<0.05).The femoral vein blood flow velocity and blood flow of the two groups decreased 1 day after operation(P<0.05),but the study group was higher than the control group(P<0.05).Compared with the first day after operation,the VAS scores of the two groups decreased 3 days after operation(P<0.05).Compared with the control group,the VAS scores of the study group were lower 1 day and 3 days after operation(P<0.05).The levels of noradrenaline(NE),aldosterone(ALD)and cortisol(Cor)in the two groups increased 1 day after operation(P<0.05),but the levels in the study group were lower than those in the control group(P<0.05).The incidence of complications in the study group(7.14%)was lower than that in the control group(23.81%)(P<0.05).Conclusion The application of TEP in the treatment of elderly patients with inguinal hernia can reduce the amount of intraoperative bleeding,shorten the operation and recovery time,relieve the pain degree of patients,reduce the incidence of complications,and has little impact on the femoral vein blood flow velocity,blood flow and stress response.
作者
朱柏炼
王之旭
邱剑文
赖扬城
ZHU Bailian;WANG Zhixu;QIU Jianwen;LAI Yangcheng(Department of Gastrointestinal Surgery,Longyan Second Hospital,Longyan Fujian 364000,China)
出处
《中国卫生标准管理》
2022年第24期96-100,共5页
China Health Standard Management
关键词
腹腔镜全腹膜外疝修补术
腹股沟疝
老年患者
股静脉血流速度
围术期
应激反应
laparoscopic total extraperitoneal hernia repair
inguinal hernia
elderly patients
femoral vein blood flow velocity
perioperative period
stress response
