腹膜前间隙无张力疝修补术与疝环填充式无张力疝修补术治疗男性腹股沟疝患者的效果比较

Comparison of effects of tension-free hernia repair in the preperitoneal space and mesh plug hernia repair in male patients with inguinal hernia

目的:比较腹膜前间隙无张力疝修补术与疝环填充式无张力疝修补术治疗男性腹股沟疝患者的效果。方法:选取150例男性腹股沟疝患者为研究对象,按照随机数字表法分为观察组与对照组各75例。对照组行疝环填充式无张力疝修补术治疗,观察组行腹膜前间隙无张力疝修补术治疗,比较两组围术期指标(术中出血量、手术时间、首次下床时间与住院时间)水平、炎性因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平、住院期间并发症发生率、术后1年复发率和健康调查简表(SF-36)评分。结果:观察组术中出血量低于对照组,首次下床活动时间、住院时间短于对照组,差异有统计学意义(P<0.05);术后1 d,观察组IL-6、TNF-α水平均低于对照组,差异有统计学意义(P<0.05);住院期间,观察组并发症发生率为5.33%,明显低于对照组的17.33%,差异有统计学意义(P<0.05);术后1个月,观察组SF-36各维度评分高于对照组,差异有统计学意义(P<0.05);两组手术时间和术后1年复发率比较,差异无统计学意义(P>0.05)。结论:腹膜前间隙无张力疝修补术治疗男性腹股沟疝患者可改善围术期指标水平,降低炎性因子水平和并发症发生率,以及提高SF-36评分,效果优于疝环填充式无张力疝修补术治疗。

Objective:To compare effects of tension-free hernia repair in the preperitoneal space and mesh plug hernia repair in male patients with inguinal hernia.Methods:150 male patients with inguinal hernia were selected as the research objects and were divided into observation group and control group according to the random number table method,75 cases in each.The control group received mesh plug hernia repair,while the observation group was given the tension-free hernia repair in the preperitoneal space.The levels of perioperative indicators(intraoperative blood loss,operation time,first ambulation time and hospitalization time),the inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),and inflammatory factors]levels,the complication rate during the hospitalization,the 1-year postoperative recurrence rate,and the short form health survey(SF-36)score were compared between the two groups.Results:The intraoperative blood loss in the observation group was lower than that in the control group;the first ambulation time and the hospitalization time were shorter than those in the control group;and the differences were statistically significant(P<0.05).One day after the surgery,the levels of IL-6 and TNF-αin the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).During the hospitalization,the incidence of complications in the observation group was 5.33%,which was significantly lower than the control group of 17.33%.and the difference was statistically significant(P<0.05).1month after the surgery the score of SF-36 in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).However,there were no significant differences in the operation time and the 1-year recurrence rate between the two groups(P>0.05).Conclusions:The tension-free hernia repair in the preperitoneal space in the male patients with inguinal hernia can improve the perioperative indicator levels,reduce the inflammatory factor levels and the complication rate,and improve the SF-36 score.Moreover,it is superior to the mesh plug hernia repair.