疝环充填式无张力疝修补术治疗腹股沟疝疗效及对患者微环境相关指标的影响

Clinical effect of mesh plug tension-free hernia repair on inguinal hernia and its impact on microenvironment related indicators

目的探讨疝环充填式无张力疝修补术治疗腹股沟疝的临床疗效及对患者微环境相关指标的影响。方法选择于我院收治的128例腹股沟疝患者,每组64例。对照组行传统疝修补术,观察组行疝环充填式无张力疝修补术,比较两组治疗效果及术后1 d微环境相关指标水平。结果与对照组比较,观察组术中出血量明显减少,下床活动时间、住院时间明显缩短(P<0.01),手术时间则无显著统计学差异(P>0.05)。与对照组术后同时点相比,观察组术后1、3 d VAS评分均有明显降低(P<0.01)。与对照组术后1 d比较,观察组的血清β-内啡肽(β-EP)水平显著降低,总抗氧化能力(T-AOC)、生长激素(GH)、胰岛素(In S)水平显著升高(P<0.01);血清基质金属蛋白酶(MMP-2、MMP-9)以及基质金属蛋白酶的组织抑制剂(TIMP-1、TIMP-2)水平显著降低(P<0.01)。观察组急性尿潴留、阴囊积液、术后疼痛发生率及术后复发率与对照组比较均显著降低(P<0.01),两组低热发生率比较无明显差异(P>0.05)。结论疝环充填式无张力疝修补术治疗腹股沟疝疗效显著,并发症少,复发率低,且对微环境相关指标影响较轻。

Objective To investigate the clinical effect of mesh plug tension-free hernia repair on inguinalhernia and its impact on microenvironment related indicators in patients. Methods A total of 128 cases of patientswith inguinal hernia admitted in our hospital were divided into control group and observation group with 64 cases ineach group. The control group was treated with traditional hernioplasty,while the observation group mesh plug ten-sion-free hernia repair. The clinical effect and microenvironment related indicators 1 d after the operation were com-pared between the two groups. Results Compared with the control group,the observation group had less bloodloss during the surgery,and shorter time for recovery of out-of-bed ambulation and hospitalization（P〈 0.01）,butno significant difference was found regarding surgery hours（P〉0.05）. The VAS scores of the observation groupwere significantly lower than those of the control group at the same time points 1 and 3 days after operation（P 〈0.01）. Compared with those of control group 1 day after operation,the serum beta-endorphin（β-EP）of observa-tion group was significantly reduced,but total antioxidant capacity（T-AOC）,growth hormone（GH）,insulin（In S）level increased significantly（P〈0.01）. Serum matrix metalloproteinases-9（MMP-2 and MMP-9）and tis-sue inhibitor of matrix metalloproteinases（TIMP-1 and TIMP-2）were significantly reduced（P〈0.01）. Acute uri-nary retention,scrotal effusion,the incidence of postoperative pain and postoperative recurrence rate of observa-tion group were significantly reduced when compared with those of control group（P〈0.01）;there was no differ-ence of incidence of low thermal between the two groups（P〉0.05）. Conclusion Mesh plug tension-free herniarepair has a significant clinical effect on inguinal hernia with less complications,lower recurrence rate and lighterimpact on microenvironment related indicators.