比较分析不同补片对腹腔镜经腹腹膜前疝修补术（TAPP）术后老年腹股沟疝患者疼痛及血浆自由基等的影响。

选取2016年3月至2018年3月于南通大学附属如皋市人民医院普外科就诊的188例老年腹股沟疝患者作为研究对象。按数字表法，随机将患者分为试验组和对照组，每组94例。所有患者均择期行TAPP，术中对试验组患者使用聚丙烯和聚乳酸复合补片，对照组患者使用聚酯补片。观察并比较2组患者术后的视觉模拟评估法（VAS）评分、血浆自由基水平、并发症及复发率。

2组患者在术后12、24、48 h的VAS评分逐渐下降（P<0.05），但2组患者相同时间点下的VAS评分比较差异无统计学意义（P>0.05）。手术后，2组患者的超氧化物歧化酶水平低于术前，且对照组显著低于试验组（P<0.05）。2组患者术后丙二醛水平比术前升高，且对照组显著高于试验组（P<0.05）。2组患者术后尿潴留、血清肿、慢性疼痛以及伤口感染率等并发症发生情况均无显著性差异，且复发率差异也无统计学意义（P>0.05）。

聚丙烯和聚乳酸复合补片以及聚酯补片在老年腹股沟疝患者TAPP治疗过程中疗效相当，其中聚丙烯和聚乳酸复合补片在减轻损伤，改善血浆自由基水平方面效果更加显著，值得临床进一步研究。

To investigate the effects of different meshes on the score of pain and plasma free radicals in elderly patients with inguinal hernia after laparoscopic trans-abdominal anterior peritoneal hernia repair (TAPP).

From March 2016 to March 2018, 188 elderly patients with inguinal hernia treated in General Surgery Department of Rugao People's Hospital affiliated to Nantong University were selected as the research subjects. According to the number table method, patients were randomly divided into experimental group and control group, 94 cases in each group. All patients received TAPP at an elective time. Polypropylene and polylactic acid composite mesh was used in the experimental group, and polyester mesh was used in the control group. Visual analogue scale (VAS) score, plasma free radical level, complication and recurrence rate were observed and compared between the two groups.

The scores of VAS in the two groups decreased gradually at 12, 24 and 48 hours after operation (P<0.05), but there was no significant difference between the two groups at the same time point (P>0.05). After operation, the level of superoxide dismutase (SOD) in the two groups was lower than that before operation, and the level of SOD in the polyester group was significantly lower than that in the composite group (P<0.05). The level of malondialdehyde (MDA) in the two groups was higher than that before operation, and the level of MDA in the polyester group was significantly higher than that in the composite group (P<0.05). There was no significant difference in the incidence of complications such as urinary retention, seroma, chronic pain and wound infection between the two groups, and the recurrence rate was not significant (P>0.05).

Polypropylene and polylactic acid composite meshes and polyester, meshes are effective in the treatment of TAPP in elderly patients with inguinal hernia, and polypropylene and polylactic acid composite meshes are more effective in reducing injury and improving levels of plasma free radicals, which is worthy of further clinical study.