腹腔镜下无张力疝修补术与开放性手术治疗对成年疝气患者炎症因子、氧化应激因子水平的影响

Effects of Laparoscopic Tension-Free Hernia Repair and Open Surgery on the Levels of Inflammatory Factors and Oxidative Stress Factors in Adult Hernias Patients

目的探讨腹腔镜下无张力疝修补术(TFH)与开放性手术治疗成年疝气患者的临床效果。方法选取2021年3月—2023年3月兰陵县人民医院收治的86例成年疝气患者为研究对象,按随机数字表法将其分为对照组和观察组,各43例。对照组采用开放性手术治疗,观察组采用腹腔镜下TFH治疗。比较两组手术情况、炎症因子水平、氧化应激因子水平、疼痛程度及并发症发生情况。结果观察组手术时间为(76.98±6.34)min,长于对照组的(65.44±6.27)min,术中出血量为(19.58±2.13)mL,少于对照组的(35.74±3.59)mL,下床活动、肛门排气及住院时间分别为(22.41±2.38)h、(15.34±1.33)h、(4.35±0.42)d,均短于对照组的(30.54±3.67)h、(18.74±1.52)h、(6.08±1.14)d,组间差异有统计学意义(P<0.05)。术后24 h,观察组C反应蛋白、肿瘤坏死因子-α及白细胞介素-6水平均低于对照组,组间差异有统计学意义(P<0.05);观察组丙二醛水平低于对照组,超氧化物岐化酶水平高于对照组,组间差异有统计学意义(P<0.05);术后6、24及48 h,观察组疼痛视觉模拟评分均低于对照组,组间差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论腹腔镜下TFH治疗成年疝气效果更佳,可降低炎症因子水平及减少氧化损伤,降低术后疼痛程度,且并发症少。

Objective To investigate the clinical effect of laparoscopic tension-free hernia repair(TFH)and open surgery in adult patients with hernia.Methods Eighty-six adult hernia patients admitted to Lanling County People's Hospital from March 2021 to March 2023 were selected as the research objects,and were divided into a control group and an observation group according to random number table method,with 43 cases in each group.The control group received open surgery,and the observation group received laparoscopic TFH treatment.The operation status,levels of inflammatory factors,levels of oxidative stress factors,pain degree and occurrence of complications of the two groups were compared.Results The operative time of the observation group was(76.98±6.34)min,which was longer than(65.44±6.27)min of the control group,and the intraoperative blood loss was(19.58±2.13)mL,which was lower than(35.74±3.59)mL of the control group,the duration of getting out of bed,anal exhaust and hospitalization were(22.41±2.38)h,(15.34±1.33)h and(4.35±0.42)d,respectively,which were shorter than(30.54±3.67)h,(18.74±1.52)h and(6.08±1.14)d in the control group,and the differences between the groups were statistically significant(P<0.05).24 hours after operation,the levels of C-reactive protein,tumor necrosis factor-αand interleukin-6 in observation group were lower than those in control group,and the differences between the groups were statistically significant(P<0.05);the level of malondialdehyde in observation group was lower than that in control group,and the level of superoxide dismutase was higher than that in control group,and the differences between the groups were statistically significant(P<0.05);at 6,24 and 48 hours after operation,the pain Visual Analogue Scale of the observation group were lower than those of the control group,and the differences between the groups were statistically significant(P<0.05).The incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion Laparoscopic TFH is more effective in the treatment of adult hernia,which can reduce the level of inflammatory factors and oxidative damage,reduce the degree of postoperative pain,and have fewer complications.