不同补片用于腹股沟疝腹腔镜手术中的安全性及对患者功能康复的影响

The safety of different patches in laparoscopic inguinal hernia surgery and the influence on functional rehabilitation of patients

目的探究不同补片用于腹股沟疝腹腔镜手术中的安全性及对患者功能康复的影响。方法选取2021年3月至2023年2月德驭医疗马鞍山总医院收治的80例腹股沟疝患者,采用随机数字表法随机分为平片组(疝修补平片)和3D组(3D补片),各40例,比较2组患者手术指标,肠胃功能,手术前后患者的疼痛程度及炎症因子水平,记录并发症发生情况。结果3D组患者手术时间短于平片组,术中出血量小于平片组(P均<0.05);2组肠鸣音恢复、首次肛门排气、首次进食及首次排便时间比较,差异均无统计学意义(P均>0.05);术后1、2 d,2组患者疼痛视觉模拟评分(VAS)均先上升后降低,但3D组VAS评分低于平片组(P均<0.05);术后1 d,2组患者白细胞计数、C反应蛋白、白细胞介素-6及降钙素原水平均升高,但3D组低于平片组(P均<0.05);2组并发症总发生率比较,差异无统计学意义(P<0.05)。结论3D补片用于成人腹股沟疝腹腔镜修补术中可减轻术后疼痛,缓解炎症反应,且不影响术后胃肠功能恢复,安全性较高。

Objective To explore the safety of different patches in laparoscopic surgery on functional rehabilitation of adult patients with inguinal hernia.Methods 80 patients with inguinal hernia admitted to Maanshan General Hospital from March 2021 to February 2023 were selected and randomly divided into a flat patch group(hernia repair flat patch)and a 3D group(3D patch)by the random number table method,with 40 cases in each group.Surgical indicators,gastrointestinal function,pain before surgery and at 1 day and 2 days after surgery and inflammatory factors before surgery and at 1 day after surgery were compared between the two groups,and the complications were recorded.Results The surgical time in the 3D group was shorter than that in the flat patch group,and the intraoperative blood loss was less than that in the flat patch group(all P<0.05).There were no statistically significant differences in bowel sound recovery time,the first anal exhaust time,the first feeding time,or the first defecation time(all P>0.05).At 1 day and 2 days after surgery,the Visual Analogue Scale(VAS)score in the two groups was increased first and then decreased,but the score in the 3D group was lower than that in the flat patch group(all P<0.05).The levels of white blood cell count(WBC),C-reactive protein(CRP),interleukin-6(IL-6)and procalcitonin(PCT)were enhanced in both groups 1 day after surgery,but the levels in the 3D group were lower than those in the flat patch group(all P<0.05).The total incidence rate of the two group was no significant difference(P>0.05).Conclusion The application of a 3D patch for adult inguinal hernia repair in laparoscopic surgery can improve the surgical effect,alleviate the postoperative pain,relieve the inflammatory response,and it does not affect the recovery of gastrointestinal function after surgery,with high safety.