成人腹股沟疝开放及腹腔镜术后炎性反应及并发症比较

目的探讨开放式以及腹腔镜手术方式对成人腹股沟疝患者炎性反应及相关并发症的影响差异。 方法选择2020年1月至2021年12月，在安徽省皖南康复医院·芜湖市第五人民医院完成腹股沟疝手术的60例患者的数据资料，进行回顾性分析。依手术方法分为对照组和观察组，各30例。对照组采用开放无张力疝修补术，观察组采用腹腔镜经腹腹膜前疝修补术（TAPP）。对比2组患者的手术耗时、失血量、切口长度、肛门排气时间、总住院时间、总医疗费用、切口疼痛持续时间、术后12 h疼痛程度、术后并发症指标。对比2组患者术前以及术后48 h的血清炎性反应指标[C反应蛋白（CRP），白介素-6、降钙素原]。 结果观察组的失血量、切口长度、肛门排气时间、总住院时间低于对照组，观察组的总医疗费用高于对照组（P<0.05）。2组手术耗时差异无统计学意义（P>0.05）。观察组切口疼痛时间、术后VAS评分均低于对照组（P<0.05）。2组患者术后并发症发生率差异无统计学意义（P>0.05）。术后48 h，2组患者的血清CRP、白介素-6、降钙素原均增高（P<0.05），观察组患者的CRP、白介素-6、降钙素原水平低于对照组（P<0.05）。 结论腹腔镜经腹腹膜前疝修补术组织创伤程度低，术后恢复速度快，疼痛感低，安全性良好，有利于控制术后的炎性反应水平。

Comparison of inflammatory reaction and complications after open and laparoscopic surgery in adult patients with inguinal hernia

ObjectiveTo investigate the difference of open and laparoscopic surgery on inflammatory reaction and related complications in adult patients with inguinal hernia. MethodsData of 60 patients who completed inguinal hernia surgery in Anhui Wannan Rehabilitation Hospital, the Fifth People's Hospital of Wuhu from January 2020 to December 2021 were retrospectively analyzed. All patients were divided into control group and observation group according to different surgical methods with 30 cases in each group. The control group was treated with open tension-free hernia repair. The observation group received laparoscopic trans-abdominal preperitoneal hernia repair (TAPP). The operation time, blood loss, incision length, anal exhaust time, total hospital stay, total medical cost, incision pain duration, pain degree 12 hours after surgery, and postoperative complications of the two groups were compared. The serum inflammatory reaction indexes (CRP, IL-6, PCT) of the two groups were compared before and 48 hours after operation. ResultsThe blood loss, incision length, anal exhaust time and total hospital stay in the observation group were lower than those in the control group, and the total medical cost in the observation group was higher than that in the control group (P<0.05). There was no significant difference in operation time between the two groups (P>0.05). The time of incision pain and postoperative VAS score in the observation group were lower than those in the control group (P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). The serum CRP, IL-6 and PCT increased 48 hours after operation in both groups (P<0.05). The levels of CRP, IL-6 and PCT in the observation group were lower than those in the control group (P<0.05). ConclusionLaparoscopic TAPP for inguinal hernia patients has low tissue trauma, fast postoperative recovery, low postoperative pain, which is safe and beneficial to control the level of postoperative inflammatory response.