腹腔镜完全腹膜外疝修补术治疗老年腹股沟疝的疗效及对血清胃泌素和胃动素的影响

A prospective controlled study of the effect and treatment of total extraperitoneal laparoscopic inguinal hernia repair on serum gastrin and motilin in elderly patients with inguinal hernia

目的探讨腹腔镜完全腹膜外疝修补术(TEP)对老年腹股沟疝患者的治疗效果,以及对患者血清胃泌素(GAS)和胃动素(MOL)的影响。方法将2018年1月至2019年12月马鞍山市中心医院收治的120例老年腹股沟疝患者随机分为对照组和试验组,每组患者60例。对照组行开放无张力腹股沟疝修补术,试验组行TEP。比较2组手术相关临床参数、手术前后血清GAS及MOL水平,记录术后并发症及复发情况。结果与对照组比较,试验组手术时间、术后疼痛持续时间及住院时间均明显缩短,术中出血量明显减少,术后自主活动时间明显提前,差异均有统计学意义(均P<0.05)。术后3 d,对照组血清GAS和MOL水平较术前降低,且低于试验组,差异均有统计学意义(均P<0.05)。对照组总并发症发生率高于试验组,差异有统计学意义(P<0.05)。随访12个月,对照组复发1例,试验组无复发病例。结论采用TEP对老年腹股沟疝患者进行治疗,可缩短手术时间,减少术中出血,减轻患者术后疼痛,有利于患者术后胃肠动力的恢复。

Objective To study the efficacy and safety of laparoscopic totally extra-peritoneal(TEP)on serum gastrin and motilin for elderly patients with inguinal hernia.Methods 120 elderly patients with inguinal hernia admitted to our hospital from January 2018 to December 2019 were divided into the experiment group and the control group according to random number table method,60 cases in each group.The control group underwent open tension-free inguinal hernia repair,the experiment group performed TEP.The clinical parameters of the 2 groups,the levels of serum gastrin(GAS)and motilin(MOL)before and after operation were compared,the postoperative complications and recurrence were recorded.Results Compared with the control group,the operation time,postoperative pain duration and hospitalization duration of the experiment group significantly shortened,the intraoperative blood loss significantly reduced,the postoperative spontaneous activity time significantly advanced(P<0.05).The levels of serum GAS and MOL 3 d after operation in the control group were significantly lower than those before operation,and significantly lower than those in the experimental group(P<0.05).The incidence of total complications in the control group was significantly higher than that in the experiment group(P<0.05).During the follow-up of 12 months,there was 1 recurrence in the control group,and there was no recurrence in the experiment group.Conclusion TEP in the treatment of elderly patients with inguinal hernia can significantly shorten the operation time,reduce intraoperative bleeding and postoperative pain,which is conducive to the recovery of postoperative gastrointestinal motility.