回顾性对比分析TAPP与平片式无张力疝修补对腹股沟疝患者血清IL-6、TNF-α、MDA、TAC的影响

Retrospective Analysis of the Effects of TAPP and Flat-Sheet Tension Hernia Repair on Serum IL-6,TNF-α,MDA and TAC in Patients with Inguinal Hernia

目的探讨腹腔镜经腹腔腹膜前修补术(TAPP)与平片式无张力疝修补对腹股沟疝患者血清白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)、丙二醛(MDA)、总抗氧化能力(TAC)的影响。方法选取2019年1月—2023年1月博爱县人民医院收治的60例腹股沟疝患者临床资料,按照不同手术方案分为两组,其中采用TAPP治疗的30例为研究组,采用平片式无张力疝修补治疗的30例为对照组。对比两组围手术期指标、住院时间、手术费用、视觉模拟评分(VAS)、应激指标(IL-6、TNF-α、MDA、TAC)、并发症。结果与对照组相比,研究组手术费用较多,手术时间、恢复正常活动时间、住院时间、下床活动时间较短,出血量较少(P<0.05);与对照组相比,术后1 d、3 d,研究组疼痛评分较低,且疼痛持续时间较短(P<0.05);治疗后1 d与对照组相比,研究组IL-6、IL-8、MDA较低,TAC较高,差异有统计学意义(P<0.05);治疗后,研究组(3.33%)并发症发生率低于对照组(23.33%)(P<0.05)。结论与平片式无张力疝修补术相比,TAPP治疗腹股沟疝患者并发症更少,能减轻疼痛程度、促进术后恢复、减少应激反应,但费用较高。

Objective To analyze the effects of laparoscopic preperitoneal repair(TAPP)and flat-sheet hernia repair on serum interleukin-6(IL-6),tumor necrosis factorα(TNF-α),malondialdehyde(MDA),total antioxidant capacity(TAC)in patients with inguinal hernia.Methods The clinical data of 60 patients with inguinal hernia treated in Boai County People's Hospital from January 2019 to January 2023 were selected and divided into two groups according to different surgical schemes,including 30 cases treated with TAPP as the study group and 30 cases treated with flat tension-free hernia repair as the control group.The perioperative indicators,hospitalization time,operation costs,visual analogue scale(VAS),stress indicators(IL-6,TNF-α,MDA,TAC)and complications were compared between the two groups.Results Compared with the control group,the study group had more operation costs,shorter operation time,recovery time,hospitalization time,ambulation time and less bleeding(P<0.05).Compared with the control group,the pain score of the study group was lower and the duration of pain was shorter at 1 d and 3 d after operation(P<0.05).One day after treatment,IL-6,IL-8 and MDA in the study group were significantly lower than those in the control group,while TAC was significantly higher than that in the control group,the differences were statistically significant(P<0.05).After treatment,the incidence of complications in the study group(3.33%)was lower than that in the control group(23.33%)(P<0.05).Conclusion Compared with the flat tension-free hernia repair,TAPP in the treatment of inguinal hernia has fewer complications,can reduce the degree of pain,promote postoperative recovery and reduce stress reaction,but the cost is higher.