临床误诊误治2023，Vol.36Issue(9)：58-62,5.DOI:10.3969/j.issn.1002-3429.2023.09.013
腹腔镜联合腹壁小切口疝回纳修补术对老年腹股沟疝伴疝环粘连的治疗效果
Effect of Laparoscopic Ventral and Incisional Hernia Repair in the Treat-ment of Senile Inguinal Hernia with Hernia Ring Adhesion
摘要
Abstract
Objective To investigate the effect of laparoscopic ventral and incisional hernia repair(LVHR)in the treatment of senile inguinal hernia with hernia ring adhesion.Methods A total of 100 elderly patients with inguinal hernia and hernia ring adhesion treated from January 2020 to August 2022 were selected as the research subjects and divided into con-trol group and observation group according to different surgical methods,with 50 cases in each group.The control group un-derwent open surgery,and the observation group underwent LVHR.The intraoperative conditions,complications,postopera-tive recovery indexes,surgical incision satisfaction,incision scar rate,recurrence rate,stress indexes before and after surgery[serum cortisol(Cor),aldosterone(ALD),noadrenaline(NE)],intestinal mucosal barrier function[plasma glutamine(Gln),diamine oxidase(DAO)and urinary intestinal fatty acid binding protein(IFABP)]were compared between the two groups.Results The intraoperative blood loss and incision length of observation group were lower or shorter than those of control group(P＜0.01).At 1 d after operation,serum ALD,NE,Cor,plasma DAO and urinary IFABP levels in observa-tion group were lower than those in control group,and plasma Gln levels were higher than those in control group(P＜0.05).The time of anal exhaust,length of hospital stay and time of off-bed activity in the observation group were shorter than those in the control group,and the visual analogue scale scores at 1 d after operation were lower in the observation group than in the control group(P＜0.01).The total complication rate of the observation group was lower than that of the control group(P＜0.01).At 3-month follow-up after the operation,the incision satisfaction of the observation group was higher than that of the control group(P＜0.01),and there was no significant difference in the scar rate and recurrence rate of the incision between the two groups(P＞0.05).Conclusion LVHR is effective in the treatment of elderly patients with inguinal hernia and her-nia ring adhesion,which can reduce body stress response,improve intestinal mucosal barrier function,and effectively promote postoperative recovery of patients.关键词
疝,腹股沟/老年人/腹腔镜/小切口疝回纳修补术/疝环粘连/皮质醇/谷氨酰胺/并发症Key words
Hernia,inguinal/Elderly/Laparoscopes/Small incision hernia repair/Hernia ring adhesion/Cortisol/Glutamine/Complications分类
医药卫生引用本文复制引用
仲任,吴岑,高志慧,蔡兵..腹腔镜联合腹壁小切口疝回纳修补术对老年腹股沟疝伴疝环粘连的治疗效果[J].临床误诊误治,2023,36(9):58-62,5.基金项目
江苏省自然科学基金项目(200818JS311) （200818JS311）
南通市卫生健康委员会科研课题(QB2021040、MSZ2022088) （QB2021040、MSZ2022088）
