疝环充填式网塞无张力修补腹股沟疝对机体免疫功能的影响

Effect of mesh plug tension-free inguinal hernioplasty on immune function

目的探讨疝环充填式网塞无张力修补腹股沟疝对机体免疫功能的影响。方法选择2016年12月至2018年1月在汉中市中心医院诊治的腹股沟疝患者240例,根据手术治疗方法的不同分为观察组140例与对照组100例,对照组给予Lichtenstein修补治疗,观察组给予疝环充填式网塞无张力修补治疗,流式细胞术和酶联免疫吸附试验检测机体免疫功能的变化。结果所有患者都顺利完成手术,两组手术时间、术后恢复时间与住院时间对比差异无统计学意义(P>0.05)。观察组术后1个月的切口感染、阴囊水肿、血肿、疼痛等并发症发生率为2.9%,对照组为19.0%,观察组显著低于对照组(P<0.05)。术后1个月观察组与对照组CD3+T淋巴细胞值均升高,CD4+T淋巴细胞、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子(tumor necrosis factor-α,TNF-α)与C反应蛋白(C-reactive protein,CRP)值降低,与术后1 d对比差异有统计学意义(P<0.05)。结论疝环充填式网塞无张力修补腹股沟疝能促进机体免疫功能的恢复,减少术后并发症发生率,有很好的推广价值。

Objective To explore the effect of mesh plug tension-free inguinal hernioplasty on immune function.Methods 240 patients with inguinal hernia treated in Hanzhong Central Hospital from December 2016 to January 2018 were selected as the subjects of this study.The patients were divided into observation group(140 cases)and control group(100 cases)according to the different surgical treatment methods.The patients of control group was treated with Lichtenstein repair,and the patients of observation group was treated with mesh plug tension-free inguinal hernioplasty.Changes in the immune function are detected by Flow cytometry and enzyme-linked immunosorbent assay ELISA.Results There were no significant difference in the operation time,postoperative recovery time and hospitalization time between the two groups(P>0.05).The incidence of complications such as wound infection,scrotal edema,hematoma,and pain at 1 month postoperatively was counted.The incidence of the complications above in the observation group and the control group were 2.9%and 19.0%,respectively,and the the complication incidence of observation group was significantly lower than that of the control group(P<0.05),the CD3+values of the observation group and the control group were significantly increased one month after operation,while CD4+,IL-6,TNF-αand CRP values were significantly lower in the patients of observation group.Compared with the postoperative day,the difference was statistically significant(P<0.05).Conclusions The mesh plug tension-free inguinal hernioplasty can promote the recovery of immune function and reduce the incidence of postoperative complications.It is valuableto for broad range of application.