腹腔镜腹股沟疝修补术对男性患者术后疼痛和生殖功能影响的前瞻性随机对照研究

目的探讨腹腔镜腹股沟疝修补术手术对患者术后疼痛情况及生殖功能的影响。 方法选择2016年1月至2017年10月在新疆医科大学第一附属医院肝脏·腹腔镜外科进行腹腔镜手术治疗的150例男性腹股沟患者。按照数字表法，随机分为腹腔镜经腹腹膜前疝修补术（TAPP）组和腹腔镜完全腹膜外疝修补术（TEP）组，每组75例。观察和比较2组患者的手术指标、疼痛、精液质量、复发和并发症发生情况。手术时间、术后住院时间、术中出血量、术后疼痛时间、住院费用、疼痛数字评分（NRS）、腹股沟疼痛调查问卷评分（IPQ）、精液质量均为计量资料，使用均数±标准差（ ±s）表示，组内比较使用配对t检验，组间比较使用独立样本t检验。复发及并发症发生均为计数资料，使用频数表示，采用卡方检验进行比较。 结果TEP组患者的手术时间、术后住院时间、术中出血量、术后疼痛时间、住院费用均与TAPP组相比，差异无统计学意义（P>0.05）；术后1年TEP组患者的α-葡萄糖苷酶（α-Glu）、果糖（Fru）及酸性磷酸酶（ACP）水平均高于TAPP组，差异有统计学意义（P<0.05）；术后2组患者的NRS评分、IPQ评分、并发症发率和术后1年复发率的比较，差异无统计学意义（P>0.05）。 结论经腹腹膜前疝修补术和完全腹膜外疝修补术治疗腹股沟疝具有相同的安全性，尽管两种术式对男性精液中α-Glu、Fru及ACP水平影响存在差异，但对男性患者生殖功能并无明显影响。

Effect of laparoscopic inguinal hernia repair on postoperative pain and reproductive function for male: A prospective randomized controlled study

ObjectiveTo explore the effect on postoperative pain and reproductive function in male patients with inguinal hernia using laparoscopic inguinal hernioplasty. MethodsOne hundred and fifty male patients with inguinal hernia underwent laparoscopic surgery in the first affiliated hospital of Xinjiang medical university from January 2016 to October 2017 were randomly divided into the group A and the group E, with 75 cases in each group. The group A was treated with transabdominal preperitioneal (TAPP) repair, while the group E was treated with total extraperitoneal (TEP) repair. The surgical indicators, pain, semen quality, recurrence and complications were observed and compared between the two groups. ResultsThe differences of operation time, postoperative hospital time, bleeding volume, postoperative pain time and hospitalization expenses between the group E and group A were not significant (P>0.05). The levels of α-glucosidase (α-Glu), fructose (Fru) and acid phosphatase (ACP) in the group E were higher than those in group A one year after operation (P<0.05). There were no significant differences in the scores of numerical rating scale (NRS) and inguinal pain questionnaire (IPQ), rates of complication and recurrence one year after operation between the two groups (P>0.05). ConclusionTAPP and TEP have the same safety performance in the treatment of inguinal hernia. Although the effects of the two methods on the levels of α-Glu, fru and ACP in semen were different, there was no significant effect on the reproductive function of male patients between two procedures.