| 马 博,李建刚,王 俊,莫合买提·叶海亚,张 谦.腹腔镜TAPP与李金斯坦（Lichtenstein）疝修补术治疗腹股沟疝对血清睾酮浓度、MMP-2的影响[J].,2022,(9):1704-1707 |
| 腹腔镜TAPP与李金斯坦（Lichtenstein）疝修补术治疗腹股沟疝对血清睾酮浓度、MMP-2的影响 |
| The Effect of Laparoscopic TAPP and Lichtenstein Hernia Repair for Inguinal Hernia on Serum Testosterone Concentration and MMP-2 |
| 投稿时间：2021-11-01 修订日期：2021-11-24 |
| DOI：10.13241/j.cnki.pmb.2022.09.021 |
| 中文关键词: 腹股沟疝 腹腔镜腹膜前疝修补术 李金斯坦疝修补术 睾酮 基质金属蛋白酶-2 |
| 英文关键词: Inguinal hernia Laparoscopic preperitoneal hernia repair Li Jinstein hernia repair Testosterone Matrix metalloproteinase-2 |
| 基金项目:新疆维吾尔族自治区自然科学基金项目（2021D01C372） |
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| 中文摘要: |
| 摘要 目的：探讨腹腔镜腹膜前疝修补术（TAPP）与李金斯坦（Lichtenstein）疝修补术治疗腹股沟疝对血清睾酮浓度、基质金属蛋白酶-2（MMP-2）的影响。方法：选取2017年1月~2021年1月80例腹股沟疝患者，采用随机数字表法将其分为TAPP组（n=44）与Lichtenstein组（n=36），记录两组手术指标、术后并发症及复发率，于术前和术后1个月血清检测睾酮和MMP-2水平。结果：TAPP组术中出血量、术后肛门排气时间显著少于Lichtenstein组（P＜0.05），两组手术时间比较无差异（P＞0.05）；TAPP组术后住院时间少于Lichtenstein组，住院费用高于Lichtenstein组（P＜0.05），两组术后复发率对比无差异（P＞0.05）；TAPP组阴囊水肿发生率显著低于Lichtenstein组（P＜0.05），其它并发症组间比较无差异（P＞0.05）；两组术前术后血清睾酮均无变化（P＞0.05）。术后两组MMP-2水平均显著降低（P＜0.05），但组间比较无差异（P＞0.05）。结论：两种术式对股沟疝患者睾丸功能均无损伤，且均可有效降低血清MMP-2水平，防止股沟疝复发，安全有效；相比之下，腹腔镜ATPP创伤更小，术后恢复更快，但手术难度较大，费用较高，两种术式各有优缺点，需结合患者的实际情况选择术式。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effects of laparoscopic preperitoneal hernia repair (TAPP) and Lichtenstein hernia repair for inguinal hernia on serum testosterone concentration and matrix metalloproteinase-2(MMP-2). Methods: From January 2017 to January 2021, 80 patients with inguinal hernia were selected, and they were divided into TAPP group(n=44) and Lichtenstein group (n=36) by random number table, and the two groups of surgical indicators and surgery were recorded. For post-operative complications and recurrence rates, serum testosterone and MMP-2 levels were measured before and 1 month after surgery. Results: The amount of intraoperative blood loss and postoperative anal exhaust time in TAPP group were lower than those in Lichtenstein group (P<0.05), and there was no difference in the operative time between the two groups (P>0.05). The postoperative hospital stay in TAPP group was shorter than that in Lichtenstein group, and the hospitalization cost was higher than that in Lichtenstein group(P<0.05). There was no difference in postoperative recurrence rate between the two groups(P>0.05). The incidence of scrotal edema in TAPP group was lower than that in Lichtenstein group(P<0.05), but there was no difference in other complications among groups(P>0.05). There was no change in serum testosterone in both groups before and after operation (P<0.05). The level of MMP-2 in both groups was decreased after surgery (P<0.05), but there was no difference between groups(P>0.05). Conclusion: Both surgical methods have no damage to the testicular function of patients with inguinal hernia, and both can effectively reduce the serum MMP-2 level, prevent the recurrence of the inguinal hernia, and are safe and effective. In contrast, the laparoscopic ATPP has less trauma and the operation The recovery is faster, but the operation is more difficult and costly. The two surgical methods have their own advantages and disadvantages. The surgical method needs to be selected according to the actual situation of the patient. |
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