无张力疝修补术后患者血清炎症介质的变化

The change of serum inflammatory mediators in patients undergoing tension-free inguinal hernia repair

目的比较采用膨化聚四氟乙烯修补材料 (e PTFE)的无张力疝修补术 (LH)与传统的疝修补术 (BH)术后患者血清炎症介质的变化。方法 2 1例无并发症及无术后复发的单侧腹股沟疝的男性患者随机分为LH和BH 2组。分别于术前 2 4h ,术后 6、2 4、4 8h和 16 8h采集外周静脉血标本 ,检测中性粒细胞计数、血清纤维蛋白原 (FN)、C 反应蛋白 (CRP)、α1 抗胰蛋白酶 (α1 AT)和白细胞介素 6(IL 6 )的变化。结果与BH组患者相比 ,LH组术后患者FN、CRP、α1 AT和IL 6明显增高 ;中性粒细胞水平明显升高 ;术后镇痛药用量减少。结论较BH组而言 ,采用LH术后患者疼痛轻、恢复快 。

ObjectiveThis study was to evaluate the changes of inflamatory mediators in patients undergoing tension free hernioplasty(LH) using expanded polytetrafluoroethylene (e PTFE) mycromesh biomaterial or conventional Bassini hernia repair(BH). MethodTwenty one patients randomized into two groups receiving LH or BH. Peripheral venous blood samples were collected 24 hours prior to surgery and then 6,24,48 and 168 hours postoperatively.ResultLH patients showed a higher increased serum level of fibringen,C reactive protein,alpha 1 antitrypsin, and interleukin 6 than BH patients. Postoperative visual analogue scales for pain reduced on mobilization for patients undergoing LH compared with BH. Neutrophils significantly increased only in LH compared with baseline. ConclusionOur data show that although LH induces less pain and rapid postoperative recovery,it is associated with an higher inflammatory response compared with BH, likely due to mycromesh biomaterial.