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无张力疝修补术与针对补片的炎症反应标志物增加有关。

Tension-free hernia repair is associated with an increase in inflammatory response markers against the mesh.

作者信息

Di Vita G, Milano S, Frazzetta M, Patti R, Palazzolo V, Barbera C, Ferlazzo V, Leo P, Cillari E

机构信息

Department of Surgery, 2nd Division, University of Palermo, Palermo, Italy.

出版信息

Am J Surg. 2000 Sep;180(3):203-7. doi: 10.1016/s0002-9610(00)00445-1.

Abstract

BACKGROUND

The purpose of this study was to evaluate the involvement of inflammatory mediators in patients undergoing Lichtenstein tension-free hernioplasty (LH) using polypropylene prosthetic materials or conventional Bassini hernia repair (BH).

METHODS

Thirty patients male with unilateral inguinal hernia without complications or recurrence were included in this study. Randomly, patients underwent LH or BH. Peripheral venous bloods samples were collected 24 hours prior to surgery and then 6, 24, 48 and 168 hours postoperatively.

RESULTS

We present evidences that LH patients showed a higher increased serum level of fibrinogen, C-reactive protein, alpha-1-antitrypsin, and interleukin-6 than BH patients. Postoperative visual analogue scales for pain were reduced on mobilization for patients undergoing LH compared with BH. Neutrophils were significantly increased only in LH compared with baseline. Ceruloplasmin, transferrin, and albumin levels were unmodified after BH or LH.

CONCLUSIONS

In conclusion our data show that although LH induces less pain and more rapid postoperative recovery, it is associated with an higher inflammatory response compared with BH, likely due to polypropylene mesh.

摘要

背景

本研究旨在评估炎症介质在接受使用聚丙烯假体材料的Lichtenstein无张力疝修补术(LH)或传统Bassini疝修补术(BH)患者中的参与情况。

方法

本研究纳入30例无并发症或复发的单侧腹股沟疝男性患者。患者随机接受LH或BH手术。术前24小时以及术后6、24、48和168小时采集外周静脉血样本。

结果

我们有证据表明,LH患者的纤维蛋白原、C反应蛋白、α-1抗胰蛋白酶和白细胞介素-6血清水平升高幅度高于BH患者。与BH患者相比,接受LH手术的患者术后活动时疼痛的视觉模拟评分降低。与基线相比,仅LH患者的中性粒细胞显著增加。BH或LH术后铜蓝蛋白、转铁蛋白和白蛋白水平未改变。

结论

总之,我们的数据表明,尽管LH引起的疼痛较少且术后恢复更快,但与BH相比,它与更高的炎症反应相关,可能是由于聚丙烯补片所致。

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