腹膜前腹腔镜疝修补术与传统开放疝修补术对腹股沟斜疝患者术后应激及近期生活质量的影响

Effect of Transabdominal Preperitoneal Prosthesis Repair and Traditional Open Hernia Repairon Postoperative Stress and Recent Quality of Life in Patients with Indirect Inguinal Hernia

目的分析腹膜前腹腔镜疝修补术(TAPP)与传统开放疝修补术对腹股沟斜疝患者术后应激及近期生活质量的影响。方法以2020年6月-2023年6月抚州市临川区第二人民医院收治的106例腹股沟斜疝患者为研究对象,经随机数字表法分为TAPP组(53例)和开放组(53例)。TAPP组行TAPP治疗,开放组则采用传统开放疝修补术治疗,比较两组围术期指标[手术时间、术中出血量、术后疼痛视觉模拟评分(VAS)、术后下床活动时间]、应激指标[血浆皮质醇(Cor)、肾上腺素(AD)、C反应蛋白(CRP)]、手术并发症发生情况、生活质量[世界卫生组织生活质量测定表简表(WHOQOL-BREF)]。结果TAPP组手术时间长于开放组,但术中出血量少于开放组,术后VAS评分低于开放组,术后下床活动时间短于开放组(P<0.05);两组术后24 h的Cor、AD、CRP指标均高于术前,但TAPP组Cor、AD、CRP指标低于开放组(P<0.05);TAPP组手术并发症发生率低于开放组(P<0.05);两组术后1个月WHOQOL-BREF(生理、心理、环境、社会关系)评分高于术前,且TAPP组术后WHOQOL-BREF(生理、心理、环境、社会关系)评分高于开放组(P<0.05)。结论TAPP与传统开放疝修补术均为腹股沟斜疝有效治疗方式,前者术中出血更少、术后疼痛更小、恢复更快,可有效缓解术后应激反应,降低手术并发症风险,改善患者近期生活质量。

Objective To analyze the effects of transabdominal preperitoneal prosthesis(TAPP)repair and traditional open hernia repair on postoperative stress and recent quality of life in patients with indirect inguinal hernia.Methods A total of 106 patients with indirect inguinal hernia admitted to the Second People's Hospital of Linchuan District,Fuzhou City from June 2020 to June 2023 were selected as the research objects.They were divided into TAPP group(53 patients)and open group(53 patients)by random number table method.The TAPP group was treated with TAPP,and the open group was treated with traditional open hernia repair.The perioperative indicators[operation time,intraoperative blood loss,postoperative pain Visual Analogue Scale(VAS),postoperative ambulation time],stress indicators[plasma cortisol(Cor),epinephrine(AD),C-reactive protein(CRP)],surgical complications,quality of life[World Health Organization Quality of Life-BREF(WHOQOL-BREF)]were compared between the two groups.Results The operation time of the TAPP group was longer than that of the open group,but the intraoperative blood loss was less than that of the open group,the postoperative VAS score was lower than that of the open group,and the postoperative ambulation time was shorter than that of the open group(P<0.05).The Cor,AD and CRP indexes of the two groups at 24 h after operation were higher than those before operation,but the Cor,AD and CRP indexes of the TAPP group were lower than those of the open group(P<0.05).The incidence of surgical complications in the TAPP group was lower than that in the open group(P<0.05).The WHOQOL-BREF(physiological,psychological,environmental and social relations)scores of the two groups at 1 month after operation were higher than those before operation,and the WHOQOL-BREF(physiological,psychological,environmental and social relations)scores of the TAPP group were higher than those of the open group(P<0.05).Conclusion Both TAPP and traditional open hernia repair are effective treatment methods for indirect inguinal hernia.The former has less intraoperative bleeding,less postoperative pain and faster recovery,which can effectively relieve postoperative stress response,reduce the risk of surgical complications and improve the recent quality of life of patients.