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

目的对比腹腔镜修补术和疝环充填手术治疗腹股沟疝对患者应激反应的影响及相关并发症情况。 方法分析安徽省第二人民医院2016年3月至2018年3月收治的132例腹股沟疝患者作为研究对象，分成对照组与观察组，每组各66例，对照组通过疝环充填手术进行治疗，观察组通过腹腔镜手术进行治疗，对比2组应激因子、炎性因子、手术效果，随访12个月，记录术后并发症发生率等指标。 结果共120例患者完成手术及术后随访工作，随访率90.91%。观察组的肿瘤坏死因子-α、血浆皮质醇、C反应蛋白、中性粒细胞百分比、白细胞计数等应激因子、炎性因子水平低于对照组（P<0.05）；2组患者的术后下床活动时间、恢复工作时间、术后疼痛持续时间、住院时间等指标对比有明显差异（P<0.05）；对照组、观察组的术后发热、尿潴留、血清肿、感染、慢性疼痛、复发等差异无统计学意义，观察组的术后急性疼痛发生率明显低于对照组（P<0.05）。 结论腹股沟疝患者通过腹腔镜手术进行治疗能够获得较为理想的效果，可明显的改善应激反应与炎性因子水平，不增加术后并发症，利于患者术后恢复。

Comparative analysis of laparoscopic surgery and mesh plug repair for stress response and postoperative complications in adult inguinal hernia surgery

ObjectiveTo compare the stress response and complications of mesh plug hernia repair and laparoscopic surgery for adult inguinal hernia. Methods132 patients with inguinal hernia admitted to Ahhui No.2 Provincial people's hospital from March 2016 to March 2018 were selected as research objects. A total of 132 patients were divided into the control group and the observation group randomly, with 66 cases in each group. For treatment, the observation group was treated by laparoscopic surgery, while the control group was treated by mesh plug repair. The indexes of stress factors, inflammatory factors, surgical effects, and postoperative complications were compared between the two groups. ResultsA total of 120 patients completed surgery and postoperative follow-up, with a follow-up rate of 90.91%. Compared with the control group, TNF-α, Cor, CRP, NEUT%, WBC and other stress factors and inflammatory factors were significantly lower in the observation group (P<0.05). There were significant differences in indexes of recovery time, postoperative activity time, postoperative pain duration, and length of hospital stay (P<0.05). The complication rates (fever, urinary retention, seroma, infection, chronic pain, recurrence) in the control group and the observation group were comparable. Compared with the control group, the incidence of acute pain was lower in the observation group (P<0.05). ConclusionLaparoscopic treatment of inguinal hernia patients can achieve relatively ideal results, significantly improve the stress response and inflammatory factors, without increasing postoperative complications. It is beneficial to patients' postoperative recovery.