腹腔镜全腹膜外疝修补术对腹股沟疝患儿术后康复及VAS评分的影响(1)
摘要：目的 探讨腹腔镜全腹膜外疝修补术治疗儿童腹股沟疝的临床效果，观察其对患儿术后疼痛及康复的影响。方法 选取2018年10月～2019年12月我院收治的腹股沟疝患儿100例，按手术方案分为对照组(43例)和研究组(57例)，对照组以开放式全腹膜外疝修补术治疗，研究组采用腹腔镜全腹膜外疝修补术治疗;比较两组围术期指标(手术时间、术中失血量、术后首次下床自主活动时间、住院时间)、术后1、3 d疼痛程度(VAS评分)、手术前后应激与炎症指标[血浆皮质醇(Cor)、血清C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平及并发症发生率。结果 研究组手术时间长于对照组，术中失血量少于对照组，术后首次下床自主活动时间及住院时间均短于对照组，差异有统计学意义(P<0.05);研究组术后1、3 d VAS评分低于对照组，差异有统计学意义(P<0.05);研究组血浆Cor、血清CRP、IL-6及TNF-α水平均低于对照组，差异有统计学意义(P<0.05);研究组并发症发生率为1.75%，低于对照组的13.95%，差异有统计学意义(P<0.05)。结论 腹腔镜全腹膜外疝修补术治疗儿童腹股沟疝的临床效果突出，可有效减少术中出血，促进患儿术后康复及疼痛缓解，同时减轻了手术应激及炎性损伤，安全性较高。
关键词：儿童腹股沟疝;腹腔鏡全腹膜外疝修补术;开放式全腹膜外疝修补术;术后康复
中图分类号：R656.21 文献标识码：A DOI：10.3969/j.issn.1006-1959.2020.23.030
文章编号：1006-1959(2020)23-0106-03
Abstract：Objective To explore the clinical effect of laparoscopic total extraperitoneal hernia repair in the treatment of inguinal hernia in children， and observe its effect on postoperative pain and rehabilitation of children.Methods A total of 100 children with inguinal hernia from October 2018 to December 2019 were selected and grouped according to the surgical plan， 43 cases were treated with open total extraperitoneal hernia repair as the control group， and 57 cases were treated with laparoscopic total extraperitoneal hernia repair as the study group. The basic indexes of perioperative period (length of operation， blood loss during operation， time to get out of bed autonomously after operation， length of hospital stay)， pain degree (VAS score) after 1 dand 3 d after surgery， stress and inflammation indicators before and after surgery [plasma cortisol (Cor)， serum C-reactive protein (CRP)， interleukin-6 (IL-6)， tumor necrosis factor-α (TNF-α)] level， and the incidence of complications were compared between the two groups. Results The study group had longer operation time than the control group， and the blood loss during the operation was less than that of the control group， the time to get out of bed for the first time after surgery and hospital stay were shorter than those in the control group，the difference was statistically significant (P<0.05); the VAS scores of the study group were lower than those of the control group at 1 and 3 dafter surgery，the difference was statistically significant (P<0.05); the study group's plasma Cor， serum CRP， IL-6 and the level of TNF-α was lower than the control group， the difference was statistically significant (P<0.05); the complication rate of the study group was 1.75%， which was lower than the control group's 13.95%， the difference was statistically significant (P<0.05).Conclusion Laparoscopic total extraperitoneal hernia repair has outstanding clinical effects in the treatment of inguinal hernias in children. It can effectively reduce intraoperative bleeding， promote postoperative recovery and pain relief in children， and reduce surgical stress and inflammatory damage， with high safety., http://www.100md.com(黄永 张冬 李珊)
关键词：儿童腹股沟疝;腹腔鏡全腹膜外疝修补术;开放式全腹膜外疝修补术;术后康复
中图分类号：R656.21 文献标识码：A DOI：10.3969/j.issn.1006-1959.2020.23.030
文章编号：1006-1959(2020)23-0106-03
Abstract：Objective To explore the clinical effect of laparoscopic total extraperitoneal hernia repair in the treatment of inguinal hernia in children， and observe its effect on postoperative pain and rehabilitation of children.Methods A total of 100 children with inguinal hernia from October 2018 to December 2019 were selected and grouped according to the surgical plan， 43 cases were treated with open total extraperitoneal hernia repair as the control group， and 57 cases were treated with laparoscopic total extraperitoneal hernia repair as the study group. The basic indexes of perioperative period (length of operation， blood loss during operation， time to get out of bed autonomously after operation， length of hospital stay)， pain degree (VAS score) after 1 dand 3 d after surgery， stress and inflammation indicators before and after surgery [plasma cortisol (Cor)， serum C-reactive protein (CRP)， interleukin-6 (IL-6)， tumor necrosis factor-α (TNF-α)] level， and the incidence of complications were compared between the two groups. Results The study group had longer operation time than the control group， and the blood loss during the operation was less than that of the control group， the time to get out of bed for the first time after surgery and hospital stay were shorter than those in the control group，the difference was statistically significant (P<0.05); the VAS scores of the study group were lower than those of the control group at 1 and 3 dafter surgery，the difference was statistically significant (P<0.05); the study group's plasma Cor， serum CRP， IL-6 and the level of TNF-α was lower than the control group， the difference was statistically significant (P<0.05); the complication rate of the study group was 1.75%， which was lower than the control group's 13.95%， the difference was statistically significant (P<0.05).Conclusion Laparoscopic total extraperitoneal hernia repair has outstanding clinical effects in the treatment of inguinal hernias in children. It can effectively reduce intraoperative bleeding， promote postoperative recovery and pain relief in children， and reduce surgical stress and inflammatory damage， with high safety., http://www.100md.com(黄永 张冬 李珊)