[1]高鹏 刘雪来*① 张旭光② 关浩洋③ 曹学会④.开放和腹腔镜下经皮腹膜外疝环闭合术治疗儿童腹股沟斜疝对肠黏膜屏障功能的影响[J].中国微创外科杂志,2019,01(9):830-833.
　Gao Peng*,Liu Xuelai,Zhang Xuguang,et al.Laparoscopic Percutaneous Extraperitoneal Closure Versus Open Hernioplasty for Indirect Inguinal Hernia in Children: Comparative Study of Intestinal Mucosal Barrier Function[J].Chinese Journal of Minimally Invasive Surgery,2019,01(9):830-833.
点击复制

开放和腹腔镜下经皮腹膜外疝环闭合术治疗儿童腹股沟斜疝对肠黏膜屏障功能的影响()
分享到：

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2019年9期
页码:
830-833
栏目:
实验研究
出版日期:
2019-09-25

文章信息/Info

Title:
Laparoscopic Percutaneous Extraperitoneal Closure Versus Open Hernioplasty for Indirect Inguinal Hernia in Children: Comparative Study of Intestinal Mucosal Barrier Function
作者:
高鹏 刘雪来*① 张旭光② 关浩洋③ 曹学会④
（哈尔滨市儿童医院普外一科，哈尔滨150010）
Author(s):
Gao Peng*;  Liu Xuelai;  Zhang Xuguang;  et al.
*Department of Surgery, Harbin Children Hospital, Harbin 150010, China
关键词:
腹腔镜经皮腹膜外关闭术; 疝囊高位结扎术; 儿童; 腹股沟斜疝; 肠黏膜屏障
Keywords:
Laparoscopic percutaneous extraperitoneal closure; High hernioplasty; Child; Indirect inguinal hernia; Intestinal barrier function
文献标志码:
A
摘要:
目的比较腹腔镜经皮腹膜外关闭术（laparoscopic percutaneous extraperitoneal closure，LPEC）和开放疝囊高位结扎术(open hernioplasty,OH)治疗儿童腹股沟斜疝对肠黏膜屏障功能的影响。方法选择2018年12月~2019年3月于哈尔滨市儿童医院完成的52例儿童腹股沟斜疝，由家属选择术式，分为LPEC组（28例）和OH组（24例）。2组年龄、性别、侧数无显著差异(P>0.05)。比较2组手术时间、麻醉时间，以及手术前后尿乳果糖(lactulose)/甘露醇(mannitol)比值(L/M)、尿肠形脂肪酸结合蛋白(intestinal fatty acid binding protein,IFABP)、血D-乳酸水平。结果所有手术均顺利完成。LPEC组手术时间、麻醉时间均明显短于OH组(P=0.000)。2组术前尿L/M比值、血D-乳酸和尿IFABP无显著差异(P>0.05)。LPEC组术后1天、2天尿L/M比值，术后2 h血D-乳酸以及术后1天尿IFABP较术前均无明显差异(P>0.05)，OH组均高于术前(P<0.05)。结论与OH手术相比，LPEC手术对肠黏膜屏障功能的影响更小。
Abstract:
ObjectiveTo compare the laparoscopic percutaneous extraperitoneal closure (LPEC) and open hernioplasty (OH) in effect on intestinal mucosal barrier function for the treatment of indirect inguinal hernia in children.MethodsFrom December 2018 to March 2019, 52 children with indirect inguinal hernia in our hospital were operated, including 28 cases of LPEC and 24 cases of OH. There was no significant difference in age, gender and sides between the two groups (P>0.05). Their clinical data involving operation time, anesthesia time, urine lactulose/mannitol ratio (L/M), urine intestinal fatty acid binding protein (IFABP ) and serum Dlactic acid were summarized and compared between the two groups. ResultsAll the operations were successfully completed. The operation time and anesthesia time in the LPEC group were shorter than those in the OH group (P=0.000). And there was no significant difference in urinary L/M ratio, serum Dlactate and urine IFABP before operations between the two groups (P>0.05). No significant changes were noted in urinary L/M ratio on postoperative day 1 and day 2, serum Dlactic acid at 2 hours postoperatively, and urine IFABP in postoperative day 1 in the LPEC group as compared with preoperation (P>0.05), but significant increases were found in the OH group (P<0.05). ConclusionCompared with open hernioplasty, laparoscopic percutaneous extraperitoneal closure presents less influences on intestinal mucosal barrier function.

参考文献/References:

[1]中华医学会小儿外科学分会内镜外科学组.小儿腹股沟疝腹腔镜手术操作指南(2017版)（上篇）.中华疝和腹壁外科杂志（电子版）,2018,12(1): 1-5.
[2]中华医学会小儿外科学分会内镜外科学组.小儿腹股沟疝腹腔镜手术操作指南(2017版)（下篇）.中华疝和腹壁外科杂志（电子版）,2018,12(2): 81-85.
[3]刘琳,李索林.腹腔镜技术诊治小儿腹股沟疝的演化.中华小儿外科杂志,2016,37(10): 796-800.
[4]周小龙,李龙,吴璇昭,等.腹腔镜治疗腹股沟斜疝对小儿血CRP、IL6、IL10的影响.中国微创外科杂志,2009,9(1): 66-68.
[5]李索林,费川,张永婷,等.水分离双钩套扎针辅助单孔腹腔镜腹股沟疝腹膜外结扎术.中国微创外科杂志,2017,17(1): 42-45.
[6]陆磊,金旭文,王翬,等.腹腔镜与开腹胆囊切除术对急性结石性胆囊炎患者肠屏障功能的影响.中国微创外科杂志,2018,18(6): 523-527.
[7]Li S,Liu L,Li M.Singleport laparoscopic percutaneous extraperitoneal closure using an innovative apparatus for pediatric inguinal hernia.J Laparoendosc Adv Surg Tech A,2014,24(3): 188-193.
[8]Bertozzi M,Marchesini L,Tesoro S,et al.Laparoscopic herniorrhaphy in children.Pediatr Med Chir,2015,37(2): pmc.2015.109.
[9]李索林,刘琳.小儿腹腔镜腹股沟疝修补术.临床小儿外科杂志,2014,13(1): 71-74.
[10]Vancamelbeke M,Vermeire S.The intestinal barrier: a fundamental role in health and disease.Expert Rev Gastroenterol Hepatol,2017,11(9): 821-834.
[11]张玮,褚永果,李伟,等.肠型脂肪酸结合蛋白和D-乳酸在危重症肠黏膜屏障功能的临床研究.临床急诊杂志,2018,19(1): 6-12.
[12]Vancamelbeke M,Vermeire S.The intestinal barrier: a fundamental role in health and disease.Expert Rev Gastroenterol Hepatol,2017,11(9):821-834.
[13]高鹏,张旭光,刘雪来.肠道黏膜屏障功能评估的研究进展.发育医学电子杂志,2019,7(1):70-74.
[14]高帆,许青文,徐鹏远.D-乳酸、iFABP作为肠屏障功能障碍预警指标的生物学意义.临床医药文献电子杂志，2019,6(5):22.
[15]Denno DM,vanBuskirk K,Nelson ZC,et al.Use of the lactulose to mannitol ratio to evaluate childhood environmental enteric dysfunction: a systematic review.Clin Infect Dis,2014,59(Suppl 4): S213-S219.
[16]何志捷,植耀炜,黄超泰,等.血清二胺氧化酶、D-乳酸和细菌内毒素在重症患者肠道功能评估中的作用.岭南现代临床外科,2017,17(4): 400-403.
[17]龚玉婷,黄丹,陈志芬.急性胰腺炎患者早期血清D-乳酸、内毒素及二胺氧化酶在病情评估中的价值.武汉大学学报(医学版),2019,40(1): 112-115.
[18]宋梦莹,张丙宏.肠型脂肪酸结合蛋白的研究进展.职业与健康,2017,33(6): 839-845.
[19]Gajda AM,Storch J.Enterocyte fatty acidbinding proteins (FABPs): different functions of liver and intestinal FABPs in the intestine.Prostaqlandins Leukot Essent Fatty Acids,2015,93: 9-16.

备注/Memo

备注/Memo:
*通讯作者，Email：liuxuelai_steven@163.com①（首都儿科研究所附属儿童医院外科，北京100020）②（哈尔滨市儿童医院儿童保健科，哈尔滨150010）③（哈尔滨市儿童医院科研科，哈尔滨150010）④（河北医科大学第二医院小儿外科，石家庄050000）
更新日期/Last Update: 2019-12-10