切换至 "中华医学电子期刊资源库"

中华疝和腹壁外科杂志(电子版) ›› 2022, Vol. 16 ›› Issue (01) : 104 -107. doi: 10.3877/cma.j.issn.1674-392X.2022.01.025

临床论著

三种疝修补术治疗老年腹股沟疝患者的临床疗效比较
冯学书1, 陈大敏2,(), 朱铭玉2, 尹滇3   
  1. 1. 211200 南京,东南大学附属中大医院溧水分院护理部
    2. 211200 南京,东南大学附属中大医院溧水分院普外科
    3. 211200 南京,东南大学附属中大医院溧水分院老年科
  • 收稿日期:2020-06-09 出版日期:2022-02-18
  • 通信作者: 陈大敏

Comparative study on the clinical efficacy of three kinds of herniorrhaphy in the treatment of senile inguinal patients

Xueshu Feng1, damin Chen2,(), Mingyu Zhu2, Dian Yin3   

  1. 1. Nursing Department, Lishui Branch of Zhongshan Hospital affiliated to Southeast University,Nanjing 211200, Jiangsu Province, China
    2. General Surgery, Lishui Branch of Zhongshan Hospital affiliated to Southeast University,Nanjing 211200, Jiangsu Province, China
    3. Department of Geriatrics, Lishui Branch of Zhongshan Hospital affiliated to Southeast University,Nanjing 211200, Jiangsu Province, China
  • Received:2020-06-09 Published:2022-02-18
  • Corresponding author: damin Chen
引用本文:

冯学书, 陈大敏, 朱铭玉, 尹滇. 三种疝修补术治疗老年腹股沟疝患者的临床疗效比较[J/OL]. 中华疝和腹壁外科杂志(电子版), 2022, 16(01): 104-107.

Xueshu Feng, damin Chen, Mingyu Zhu, Dian Yin. Comparative study on the clinical efficacy of three kinds of herniorrhaphy in the treatment of senile inguinal patients[J/OL]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2022, 16(01): 104-107.

目的

探究疝环充填手术、Lichtenstein修补术与腹腔镜经腹腹膜前修补术对老年腹股沟疝患者临床疗效情况。

方法

选取2018年1月至2020年2月在东南大学附属中大医院溧水分院进行治疗的150例老年腹股沟疝患者,随机分为A组(50例)、B组(50例)及C组(50例)。A组采用疝环充填修补术、B组采用Lichtenstein修补术、C组采用腹腔镜经腹膜前修补术,观察并记录3组患者的手术时间、术后下床活动时间、术后疼痛持续时间以及术后住院时间;分别于术后1 d、7 d,采用视觉模拟评分对患者进行疼痛评估;检测术前及术后3组患者炎性因子水平:C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)以及白细胞介素-6(IL-6)水平;记录患者术后6个月内并发症发生情况。

结果

3组患者手术时间比较,差异无统计学意义(P>0.05);C组术后下床活动时间、术后疼痛持续时间及术后住院时间显著低于A组和B组(P<0.01),B组在术后疼痛持续时间上低于C组(P<0.05);术后1 d、7 d,C组VAS评分低于A组及B组,A组VAS评分低于B组(P<0.05);3组术后CRP、TNF-α以及IL-6水平均较术前显著升高,C组炎性因子水平均显著低于A组和B组(P<0.05),B组术后IL-6水平低于A(P<0.05);3组在术后6个月均未出现疝复发情况,A组并发症总发生率低于B组和C组(P<0.05),B组术后发生神经感觉异常症状高于A组(P<0.05),B组和C组并发症总发生率差异无统计学意义(P>0.05)。

结论

腹腔镜经腹腹膜前修补术治疗老年腹股沟疝患者疗效较开放式无张力疝修补术更好,对老年患者损伤更小,使其术后恢复更快,安全性更高。

Objective

To explore the clinical efficacy of hernia ring filling surgery, Lichtenstein repair, and laparoscopic trans-abdominal preperitoneal repair for elderly patients with inguinal hernia.

Methods

A total of 150 elderly patients with inguinal hernia who were treated in our hospital from January 2018 to February 2020 were selected and randomly assigned to group A (50 cases), group B (50 cases) and group C (50 cases). Group A underwent hernia ring filling repair, group B underwent Lichtenstein repair, and group C underwent laparoscopic peritoneal repair. The operation time, postoperative ambulation time, postoperative pain duration and postoperative hospital stay of 3 groups were observed and recorded. On 1 d and 7 d after surgery, pain was evaluated by a visual analog score. The levels of inflammatory factors including C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and IL-6 were detected before and after operation in 3 groups. The incidence of complications within 6 months after surgery was recorded.

Results

There was no significant difference in the operative time between the 3 groups (P>0.05). The postoperative ambulation time, postoperative pain duration and postoperative hospital stay in group C were significantly lower than those in group A and group B (P<0.05), and the postoperative pain duration in group B was lower than that in group C (P<0.05). 1 d and 7 d after surgery, VAS score of group C was lower than that of group A and group B, and the VAS score of group A was lower than that of group B (P<0.05). After operation, the levels of CRP, TNF-α and IL-6 in the 3 groups were significantly higher than those before operation, the levels of inflammatory factors in group C were significantly lower than those in group A and group B (P<0.05), and the levels of IL-6 in group B were significantly lower than those in group A (P<0.05). At 6 months after surgery, there was no recurrence of hernia in the three groups, and the total incidence of complications in group A was lower than that in group B and group C (P<0.05). The incidence of postoperative neuroparesthesia in group B was higher than that in group A (P<0.05), and there was no statistical significance in the total incidence of complications between group B and group C (P>0.05).

Conclusion

Compared with open tension-free hernia repair, laparoscopic transabdominal preperitoneal repair has better efficacy in treating elderly patients with inguinal hernia, with less damage to elderly patients, faster postoperative recovery and higher safety.

表1 3组手术效果比较(±s
表2 3组视觉模拟评分比较(±s
表3 3组炎性因子水平比较(±s
表4 3组术后6月内并发症发生情况比较[n=50,例]
[1]
马先,贺杰,马俊帅. 丹红注射液结合抗菌药物对腹股沟疝术后血清MMP-2、MMP-9、TIMP-2、TIMP-1及应激指标作用机制研究[J]. 世界中医药, 2019, 14(9): 2404-2407.
[2]
胡海斌. 补中益气汤辅助无张力疝气修补术治疗腹股沟疝患者的临床观察[J]. 中国民间疗法, 2020, 28(7): 51-53.
[3]
傅厚丰,符敏,杨河, 等. 腹腔镜下经腹腹膜前疝无张力修补术与传统术式治疗腹股沟疝患者近期效果比较[J]. 中国医药, 2019, 14(12): 1851-1853.
[4]
于涛. 有张力、无张力修补术治疗腹股沟疝气患者的临床效果对比[J]. 中国医药指南, 2021, 19(13): 108-109, 112.
[5]
中华医学会外科学分会疝与腹壁外科学组,中国医师协会外科医师分会疝和腹壁外科医师委员会. 成人腹股沟疝诊断和治疗指南(2018年版)[J]. 中华胃肠外科杂志, 2018, 21(7): 721-724.
[6]
沈亮,胡湘,李浪平, 等. PainVision法与视觉模拟评分评估腹腔镜疝修补术术后疼痛程度的相关性[J]. 上海医学, 2016, 39(6): 336-339.
[7]
赵保民. 开放式无张力疝修补术和腹腔镜手术治疗成人腹股沟疝的临床应用效果比较[J]. 首都食品与医药, 2019, 26(9): 23. 检查是否为普刊
[8]
孙凯,张泽俊,张亚等. 腹腔镜经腹腹膜前疝修补术与开放式无张力疝修补术治疗成人腹股沟疝的临床疗效[J/OL]. 中华疝和腹壁外科杂志(电子版), 2019, 13(3): 243-246.
[9]
马文恩. 有张力、无张力修补术治疗腹股沟疝气患者的临床效果对比[J]. 世界最新医学信息文摘, 2019, 19(77): 5-6.
[10]
Kroese LF, Verhelst J, Jeekel J, et al. Letter to the Editor on the article "Open ventral hernia repair using ProGrip™ self-gripping mesh"[J]. Int J Surg, 2016, 27: 190.
[11]
张洺. 腹腔镜腹膜前腹股沟疝聚丙烯补片修补术治疗成人腹股沟疝的效果[J]. 河南医学研究, 2019, 28(20): 3705-3706.
[12]
周广海. 腹腔镜腹膜前腹股沟疝聚丙烯补片修补术与开放式无张力疝修补术的临床对比研究[J]. 黑龙江中医药, 2019, 48(02): 55-56.
[13]
唐倩,梁婧,孙静茹. 腹腔镜手术与疝环充填手术对成人腹股沟疝患者应激反应及相关并发症的对比分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2020, 14(6): 642-645.
[1] 燕速, 霍博文. 腹腔镜食管胃结合部腺癌根治性切除术[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 13-13.
[2] 母德安, 李凯, 张志远, 张伟. 超微创器械辅助单孔腹腔镜下脾部分切除术[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 14-14.
[3] 李国新, 陈新华. 全腹腔镜下全胃切除术食管空肠吻合的临床研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 1-4.
[4] 李子禹, 卢信星, 李双喜, 陕飞. 食管胃结合部腺癌腹腔镜手术重建方式的选择[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 5-8.
[5] 李乐平, 张荣华, 商亮. 腹腔镜食管胃结合部腺癌根治淋巴结清扫策略[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 9-12.
[6] 陈方鹏, 杨大伟, 金从稳. 腹腔镜近端胃癌切除术联合改良食管胃吻合术重建His角对术后反流性食管炎的效果研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 15-18.
[7] 许杰, 李亚俊, 韩军伟. 两种入路下腹腔镜根治性全胃切除术治疗超重胃癌的效果比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 19-22.
[8] 李刘庆, 陈小翔, 吕成余. 全腹腔镜与腹腔镜辅助远端胃癌根治术治疗进展期胃癌的近中期随访比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 23-26.
[9] 刘世君, 马杰, 师鲁静. 胃癌完整系膜切除术+标准D2根治术治疗进展期胃癌的近中期随访研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 27-30.
[10] 任佳, 马胜辉, 王馨, 石秀霞, 蔡淑云. 腹腔镜全胃切除、间置空肠代胃术的临床观察[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 31-34.
[11] 赵丽霞, 王春霞, 陈一锋, 胡东平, 张维胜, 王涛, 张洪来. 内脏型肥胖对腹腔镜直肠癌根治术后早期并发症的影响[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 35-39.
[12] 李华志, 曹广, 刘殿刚, 张雅静. 不同入路下行肝切除术治疗原发性肝细胞癌的临床对比[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 52-55.
[13] 王庆亮, 党兮, 师凯, 刘波. 腹腔镜联合胆道子镜经胆囊管胆总管探查取石术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 313-313.
[14] 杨建辉, 段文斌, 马忠志, 卿宇豪. 腹腔镜下脾部分切除术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 314-314.
[15] 叶劲松, 刘驳强, 柳胜君, 吴浩然. 腹腔镜肝Ⅶ+Ⅷ段背侧段切除[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 315-315.
阅读次数
全文


摘要