经腹腔镜腹膜前疝修补术与无张力疝修补术治疗成人腹股沟疝的临床效果对比

Clinical effect comparison of laparoscopic preperitoneal hernioplasty and tension-free hernioplasty in the treatment of adult inguinal hernia

目的比较经腹腔镜腹膜前疝修补术(TAPP)与无张力疝修补术(TFHR)治疗成人腹股沟疝的临床效果。方法选取我院2015年1月~2018年9月收治的46例腹股沟疝患者作为研究对象,按照随机数字表法分为研究组与对照组,各23例。对照组予以TFHR治疗,研究组予以TAPP治疗。比较两组患者的手术时间、术后疼痛持续时间、住院费用、住院时间以及血清C反应蛋白(CRP)、白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、谷胱甘肽过氧化物酶(GSH-Px)、丙二醛(MDA)、超氧化物歧化酶(SOD)水平和并发症发生情况。结果研究组患者的手术时间长于对照组,术后疼痛持续时间、住院时间短于对照组,住院费用高于对照组(P<0.05)。研究组术后的CRP、TNF-α、IL-8、MDA水平低于对照组,SOD、GSH-Px水平高于对照组(P<0.05)。研究组的并发症总发生率(13.04%)显著低于对照组(43.48%)(P<0.05)。结论相较于TFHR而言,TAPP治疗成人腹股沟疝手术切口小,对炎性反应、氧化应激的影响较小,恢复快,但手术时间长,就医成本高。

Objective To compare the clinical effect of laparoscopic preperitoneal hernioplasty (TAPP) and tension-free hernioplasty (TFHR) in the treatment of adult inguinal hernia. Methods A total of 46 patients with inguinal hernia admitted to our hospital from January 2015 to September 2018 were selected as the research subjects, they were divided into the study group and the control group according to random number table method, 23 cases in each group. TFHR was given in the control group, and TAPP was given in the study group. The operation time, pain duration, hospitalization expenses, hospitalization time, the level of serum C-reactive protein (CRP), interleukin-8 (IL-8), tumor necrosis factor-alpha (TNF-α), glutathione peroxidase (GSH-Px), malondialdehyde (MDA), superoxide dismutase (SOD) and complications were compared between the two groups. Results The operation time of the study group was longer than that of the control group, the pain duration and hospitalization time of the study group were shorter than those of the control group, and the hospitalization cost of the study group was higher than that of the control group (P<0.05). The levels of CRP,TNF-α,IL-8 and MDA in the study group were lower than those in the control group, and the levels of SOD and GSH-Px were higher than those in the control group (P<0.05). The total incidence of complications in the study group (13.04%) was significantly lower than that in the control group (43.48%)(P<0.05). Conclusion Compared with TFHR, TAPP for adult inguinal hernia has smaller incision, less impact on inflammatory reaction and oxidative stress, faster recovery, but longer operation time and higher medical cost.