【摘要】 目的分析腹腔镜完全腹膜外疝修补术(TEP)和李金斯坦术式对治疗复发腹股沟疝患者疗效的影响。方法回顾性分析2012年5月至2017年5月,首都医科大学附属北京世纪坛医院接受治疗的复发腹股沟疝92例患者的临床资料,按照术式不同分为2组。试验组患者42例,行TEP术式;对照组患者50例,行李金斯坦术式。观察2组患者术中、术后并发症状况,ELISA法检测患者治疗前后血清Ⅰ型前胶原羧基端肽(PⅠCP)、基质金属蛋白酶抑制因子-1(TIMP-1)、基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶抑制因子-2(TIMP-2)及Ⅲ型前胶原羧基端肽(PⅢNP)含量。结果试验组患者术中出血量低于对照组,差异有统计学意义(P<0.05);2组手术、住院及术后下床活动时间比较,差异无统计学意义(P>0.05);治疗后试验组患者血清PⅠCP、TIMP-1、TIMP-2含量及PⅠCP/PⅢNP比值比治疗前、对照组均上升,MMP-2含量比治疗前、对照组下降,差异均有统计学意义(P<0.05);试验组术后并发症发生率为9.52%,对照组为36.00%,差异有统计学意义(P<0.05)。结论复发腹股沟疝患者行TEP较李金斯坦术式术中出血量少,术后并发症少,且可改善患者血清胶原、基质金属抑制酶与蛋白酶含量。更多还原

【Abstract】 Objective To analyze the effect of laparoscopic total extraperitoneal inguinal hernia repair(TEP) and Lichtenstein hernioplasty on recurrent inguinal hernia. Methods A retrospective analysis was conducted on 92 patients with recurrent inguinal hernia who were treated in Beijing Shijitan hospital from May 2012 to May 2017, including 42 patients with TEP as observation group and 50 patients with Lichtenstein surgery as control group. Intraoperative and postoperative complications were observed.Serum type I procollagen carboxy terminal peptide(PICP), matrix metalloproteinase inhibitor-1(TIMP-1),matrix metalloproteinase-2(MMP-2), matrix Metalloproteinase inhibitor-2(TIMP-2) and type III procollagen carboxy terminal peptide(PIIINP) content before and after treatment were detected by ELISA.Results The intraoperative blood loss of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05). There was no significant difference in the time of operation, hospitalization and postoperative outpatient activity between the two groups(P>0.05). The levels of serum PICP, TIMP-1, TIMP-2 and PICP/PIIINP in the observation group were higher than those before and after treatment. The MMP-2 content was lower than that before treatment and control group,and the difference was statistically significant(P<0.05). The incidence of postoperative complications was9.52% in the observation group and 36.00% in the control group. The difference was statistically significant(P<0.05). Conclusion Amount of bleeding in TEP patients with recurrent inguinal hernia is less than that in Lichtenstein. The postoperative complications are less, and the serum collagen, matrix metal inhibitory enzyme and protease content can be improved.更多还原