摘要
目的探究4K高清腹腔镜下经腹腹膜前修补术治疗老年腹股沟疝的临床效果及安全性。方法选取2018年1月至2022年7月如皋市中医院收治的92例老年腹股沟疝患者的病历资料行回顾性分析,按治疗方案分为2组。对照组42例,采用常规腹腔镜经腹腹膜前修补术治疗;研究组50例,采用4K高清腹腔镜联合经腹腹膜前修补术治疗。比较2组患者手术相关指标、术后疼痛程度[视觉模拟量表(VAS)评分法评估]、血气指标[动脉血二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))、pH值]、血清炎症因子水平[血清C反应蛋白(CRP)、白细胞介素⁃6(IL⁃6)],记录术后并发症发生率。结果研究组手术时间长于对照组,首次下床活动时间、住院时间短于对照组(P<0.05)。术前及术后48 h,2组患者的PaCO_(2)、PaO_(2)、pH值组间及组内差异均无统计学意义(P>0.05)。研究组术后24、48、72 h的VAS评分均低于对照组(P<0.05)。术后48 h,2组患者的CRP、IL⁃6均降低,且研究组低于对照组(P<0.05)。2组患者术后并发症发生率及复发率比较差异无统计学意义(P>0.05)。结论4K高清腹腔镜联合经腹腹膜前修补术治疗老年腹股沟疝,在促进患者术后恢复、减轻术后疼痛反应方面更具优越性,而相对于常规腹腔镜经腹腹膜前修补术,其手术时间稍长。
Objective To explore the clinical effect and safety of 4K high⁃definition laparoscopic⁃assisted transabdominal preperitoneal repair in the treatment of elderly inguinal hernia.Methods A retrospective analysis was conducted on the medical records of 92 elderly patients with inguinal hernia.They were divided into control group(n=42)and study group(n=50)according the treatment plan.Conventional laparoscopic preperitoneal repair was applied in the control group.4K high⁃definition laparoscopic⁃assisted transabdominal preperitoneal repair was used in the study group.Operation related indexes,postoperative pain(visual analogue scale[VAS]),blood gas indexed(arterial partial pressure of carbon dioxide[PaCO_(2)],arterial partial pressure of oxygen[PaO_(2)],and pH value),serum inflammatory factor levels(C⁃reactive protein[CRP]and interleukin⁃6[IL⁃6])were compared between the two groups.The incidence of postoperative complications was recorded.Results The study group had longer operation time and shorter exercise time leaving bed and hospitalization time than the control group(P<0.05).There was no statistically significant difference in the PaCO_(2),PaO_(2)or pH value between the two groups before and 48 h after operation(P>0.05).The VAS scores of the study group at 24 h,48 h and 72 h after operation were lower than those of the control group(P<0.05).The levels of CRP and IL⁃6 at 48 h after operation were decreased in both groups,and the parameters in the study group were significantly lower than those in the control group(P<0.05).There was no statistically significant difference in the incidence of postoperative complications or recurrence rate between the two groups(P>0.05).Conclusion 4K high⁃definition laparoscopic⁃assisted transabdominal preperitoneal repair has more advantages in promoting postoperative recovery and reducing postoperative pain in elderly patients with inguinal hernia.Compared with conventional laparoscopic preperitoneal repair,its operation time is slightly longer.
作者
张叶飞
刘正勇
顾海镏
冯盈
Zhang Yefei;Liu Zhengyong;Gu Hailiu;Feng Ying(Department of General Surgery,Rugao Hospital of Traditional Chinese Medicine,Nantong 226500,China)
出处
《海军医学杂志》
2024年第3期286-290,共5页
Journal of Navy Medicine
关键词
腹股沟疝
老年
腹膜前修补术
腹腔镜
Inguinal hernia
Elderly
Preperitoneal repair
Laparoscope
