摘要目的 探讨腹腔镜经腹腹膜前疝修补术（TAPP）对成人腹股沟疝患者应激激素及疼痛程度的影响。方法 选取2017年12月～2020年4月九江市第六人民医院收治的80例成人腹股沟疝患者作为研究对象，按照随机数字表法分为对照组（40例）与观察组（40例）。对照组采用开放式无张力疝修补术（TFHR），观察组采用TAPP。比较两组临床治疗总有效率、应激激素水平以及疼痛程度。结果 观察组临床治疗总有效率高于对照组，差异有统计学意义（P＜0.05）；两组术前各应激激素水平比较，差异无统计学意义（P＞0.05）；观察组术后3 d 皮质醇（Cor）、醛固酮（ALD）以及去甲肾上腺素（NE）低于对照组，差异有统计学意义（P＜0.05）；术后3 d 两组患者Cor、ALD 及NE水平均高于本组术前，差异有统计学意义（P＜0.05）；两组患者术前视觉模拟量表（VAS）评分比较，差异无统计学意义（P＞0.05）；术后3 d 观察组VAS评分低于对照组，差异有统计学意义（P＜0.05）；术后3 d 两组患者VAS评分均低于本组术前，差异有统计学意义（P＜0.05）。结论 成人腹股沟疝患者采用TAPP 治疗效果确切，临床有效率较高且患者应激反应较小，术后疼痛程度低，值得临床推广。
Abstract：Objective To explore the effect of laparoscopic transabdominal preperitoneal prosthesis (TAPP) on stress hormone and degree of pain in adult inguinal hernia.Methods A total of 80 adult patients with inguinal hernia who were admitted to the Sixth People′s Hospital of Jiujiang from December 2017 to April 2020 were selected as the research objects and divided into the control group (40 cases) and the observation group (40 cases) according to random number table method.The control group was treated with open tension-free herniorrhaphy,and the observation group underwent TAPP.The total clinical effective rate,stress hormone level,and degree of pain were compared between the two groups.Results The total clinical effective rate of the observation group was higher than that of the control group,and the difference was statistically significant (P＜0.05).There were no significant differences in stress hormone levels between the two groups before operation (P＞0.05).The cortisol (Cor),aldosterone (ALD) and norepinephrine (NE) levels at 3 d after operation in the observation group were lower than those in the control group,the differences were statistically significant (P＜0.05).The Cor,ALD and NE levels at 3 d after operation in both groups were higher than those before operation,and the differences were statistically significant (P＜0.05).There was no significant difference in preoperative visual analogue scale (VAS) score between the two groups (P＞0.05).The VAS score at 3 d after operation in the observation group was lower than that of control group,and the difference was statistically significant (P＜0.05).The VAS scores at 3 d after operation in both groups were lower than those before operation,and the differences were statistically significant (P＜0.05).Conclusion Adult inguinal hernia patients with TAPP treatment,its effect is accurate,the clinical efficiency is high,the stress response of the patients is small,the degree of postoperative pain is low,it is worth popularizing.
杨勇. 腹腔镜经腹腹膜前疝修补术对成人腹股沟疝患者应激激素及疼痛程度的影响[J]. 中国当代医药, 2021, 28(5): 75-77-92.
YANG Yong. Effect of laparoscopic transabdominal preperitoneal prosthesis on stress hormone and degree of pain in adult inguinal hernia. 中国当代医药, 2021, 28(5): 75-77-92.
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