| Objective: To compare the clinical efficacy of laparoscopic transperitoneal anterior inguinal hernia repair(TAPP)with or without Fangji Huangqi Decoction,and to observe whether Fangji Huangqi Decoction has anti-tumor effect on TAPP and pass blood plasma the expression levels of human interleukin-1 receptor antagonist(IL-1RA)in endothelial growth factor(VEGF),tumor necrosis factor ?(TNF-?)and local drainage fluid were further explored to prevent the mechanism of Fangji Huangqi Decoction in preventing and treating seroma.An effective method for the occurrence of postoperative complications of TAPP.Method: Screening out patients suitable for this subject,collecting 120 cases of inguinal hernia from TAPP surgery in the Department of Gastrointestinal Surgery of Tianjin Hospital of Integrated Traditional Chinese and Western Medicine2017.10-2018.11,including direct and oblique sputum,randomly divided into 2groups,according to random and the principle of comparison,the experimental group(oral Fangji Huangqi Decoction group)and the control group(oral Chinese medicine placebo group)were used.Both groups of patients were treated with Tianzhu D15patch(10cm × 15cm),and the preperitoneal space was used for negative pressure suction.Western medicine in the inguinal region,such as local pressure,hot compress,etc.to prevent the occurrence of seroma,the experimental group was given oral Fangji Huangqi Decoction,1 dose / day,divided into 2 times,7 days for a course of treatment.The control group received oral administration of the same dose of placebo.Record data: 1.Postoperative color Doppler ultrasound in bilateral inguinal region,compare the incidence of seroma on the 7th day after surgery and the 30 th postoperative day in the experimental group and the control group,and the patients with seroma in the two groups.Serum volume;2.The expression of VEGF and TNF-? in plasma of the experimental group and the control group on the 0th day(the day after surgery),the 3rd day and the 7th day after surgery;3.The experimental group and the control group The expression level of IL-1RA in the drainage fluid on the 0th day,the 1st day,and the 3rd day was changed.4.Evaluate the degree of anxiety in patients 1 day before surgery,7 days after surgery,and 30 days after surgery(using the SAS Anxiety Scale).Data analysis was performed using SPSS 23.0statistical software.P < 0.05 was considered statistically significant.Results: All patients enrolled completed postoperative follow-up.The data were statistically calculated and calculated.The results were as follows: 1.There was no significant difference in age,gender,inguinal hernia type,operation time,and hospitalization time between the two groups(P>0.05),ensuring the same data of the two groups of patients.2.The incidence of seroma in the experimental group and the control group was 6.7% vs 23% on the 7th day after surgery,and 0% vs 8.3% on the30 th day after surgery.The results of the two groups were statistically significant(P<0.05).The serum volume of the experimental group and the control group was0.57±0.47cm3 vs 2.29±2.03 cm3 on the 7th day after surgery,and 0 cm3vs3.21±1.09 cm3 on the 30 th day after operation.The results of the two groups were statistically different.(P<0.05);3.There was no significant difference in the levels of plasma VEGF,TNF-? between the experimental group and the control group on the0 th day after surgery and the level of IL-1RA in the drainage fluid on the 0th day after operation and the 1st postoperative day.(P>0.05);4.The levels of VEGF and TNF-?in the experimental group and the control group were 109.55±9.95pg/mlvs113.51±10.02pg/ml and 121.63 ± 8.87pg/mlvs125 on the third day after operation.78 ±11.18pg/ml,99.49 ± 10.71pg/ml vs 104.66 ± 10.91pg/ml,109.45 ± 11.21pg/ml vs115.72 ± 13.33pg/ml on the 7th day after operation and IL-1RA level in the drainage fluid Day 3 710.29 ± 78.47 pg / mlvs672.92 ± 85.75 pg / ml,the results of the two groups were significantly different(P <0.05).There was no difference in the preoperative anxiety score between the experimental group and the control group.It was 43.87±5.89 vs 46.87±8.36 on the 7th day and 42.53±4.32 vs 45.10±7.19 on the 30 th day after surgery.There was a difference(P<0.05).Conclusion: Compared with the control group,the incidence of seroma in the experimental group was low,the volume of serum was small,the expression level of VEGF and TNF-? in plasma was significantly decreased,and the expression level of IL-1RA was significantly increased.This indicates that Fangji Huangqi Decoction can reduce the incidence of seroma,accelerate the absorption of seroma,and inhibit the release of local inflammatory factors by decreasing the expression levels of VEGF,TNF-? in plasma and increasing the expression of IL-1RA.It provides clinicians with an effective way to reduce the incidence of seroma. |
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