TAPP与Lichtenstein无张力疝修补术在女性腹股沟疝治疗中的应用效果

Comparison of the Efficacy and Safety of TAPP and Lichtenstein Tension-free Hernia Repair in the Treatment of Female Inguinal Hernia

目的:探讨腹腔镜经腹腹膜前腹股沟疝修补术(TAPP)与李金斯坦(Lichtenstein)无张力疝修补术在女性腹股沟疝中的应用效果。方法:选取2015年9月—2022年9月福建医科大学附属龙岩市第一医院收治的100例女性腹股沟疝患者为研究对象,按随机数表法将其分为两组,各50例。对照组行Lichtenstein无张力疝修补术治疗,观察组行TAPP治疗。比较两组手术情况、疼痛评分、应激反应水平、炎症水平、生活质量及并发症。结果:观察组手术时间较对照组长,肛门排气时间、下床活动时间较对照组早,住院时间较对照组短,术中出血量较对照组少,差异有统计学意义(P<0.05)。术后6 h、24 h、48 h,观察组疼痛评分较对照组低,差异有统计学意义(P<0.05)。术后24 h,两组醛固酮(ALD)、皮质醇(Cor)、去甲肾上腺素(NE)水平较术前高,但观察组ALD、Cor、NE水平较对照组低,差异有统计学意义(P<0.05)。术后24 h,两组C反应蛋白(CRP)、白介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)水平较术前高,但观察组CRP、IL-6、TNF-α水平较对照组低,差异有统计学意义(P<0.05)。术后3个月,两组生活质量各领域评分较术前高,且观察组生活质量各领域评分较对照组高,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:TAPP治疗女性腹股沟疝效果更佳,可减轻机体创伤,降低应激反应及炎症水平,缩短住院时间,且术后疼痛评分低、并发症少,有助于改善生活质量。

Objective:To investigate the application effect of laparoscopic transabdominal preperitoneal inguinal hernia repair(TAPP)and Lichtenstein tension-free hernia repair surgery in female inguinal hernia.Method:A total of 100 female inguinal hernia patients admitted to Longyan First Hospital Affiliated to Fujian Medical University from September 2015 to September 2022 were selected as the study objects,and they were divided into two groups according to random number table method,with 50 cases in each group.The control group underwent Lichtenstein hernia tension-free repair surgery,and observation group underwent TAPP.The operation situation,pain score,stress response level,inflammation levels,quality of life and complications were compared between the two groups.Result:The operation time of the observation group was longer than that of the control group,the anal exhaust time and the getting out of bed time were earlier,the hospitalization time was shorter,and the intraoperative blood loss was less,the differences were statistically significant(P<0.05).After 6 h,24 h,48 h,the pain scores of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).After 24 h of operation,the levels of aldosterone(ALD),cortisol(Cor)and norepinephrine(NE)in the two groups were higher than those before operation,but the levels of ALD,Cor and NE in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After 24 h of operation,the levels of C-reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in the two groups were higher than those before operation,but the levels of CRP,IL-6 and TNF-αin the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Three months after surgery,the scores of quality of life in the two groups were higher than those before surgery,and the scores of quality of life in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).The incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:TAPP is more effective in female inguinal hernia,which can alleviate body trauma,reduce stress response and inflammation,shorten hospital stay,lower postoperative pain score and less complications,and help to improve the quality of life.