腹腔镜胃穿孔修补术治疗胃穿孔的效果及对炎症因子的影响  

Effect of laparoscopic repair of gastric perforation on gastric perforation and its influence on inflammatory factors

作　　者：路江鸿 路远 尹永鹏 井永学 汝祖平 李继松 申亚伟[2] LU Jiang-hong;LU Yuan;YIN Yong-peng;JING Yong-xue;RU Zu-ping;LI Ji-song;SHEN Ya-wei(GM Global West Air Hospital (Xi'an) Co., Ltd., Xi'an 710021;Xi'an Central Hospital, Xi'an 710003, China)

机构地区：[1]通用环球西航医院(西安)有限公司,陕西西安710021 [2]西安市中心医院,陕西西安710003

出　　处：《临床医学研究与实践》2019年第24期91-93,共3页Clinical Research and Practice

摘　　要：目的观察腹腔镜胃穿孔修补术治疗胃穿孔的效果及对炎症因子的影响。方法回顾性分析2016年2月至2018年3月我院采用腹腔镜胃穿孔修补术的53例患者(观察组)和同期采用传统开腹胃穿孔修补术的52例患者(对照组)的临床资料。比较两组患者的手术时间、术中出血量、术后下床时间、平均住院时间、住院费用、术后12、24、36、48、72 h疼痛评分、并发症发生情况、治疗前、后血清CRP、IL-1、IL-6、TNF-α水平。结果两组手术时间及住院费用比较,差异无统计学意义(P>0.05);观察组术中出血量、术后下床时间、平均住院时间均优于对照组(P<0.05)。观察组术后12、24、36、48、72 h疼痛评分均低于对照组,差异有统计学意义(P<0.05)。观察组术后腹腔脓肿、腹腔出血、粘连性肠梗阻及切口疝发生率均低于对照组(P<0.05)。治疗后,两组血清CRP、IL-1、IL-6、TNF-α水平均较治疗前降低,且观察组低于对照组,差异具有统计学意义(P<0.05)。结论腹腔镜下胃穿孔修补术治疗胃穿孔能够显著提高患者的临床治疗效果,有利于患者的病情恢复,值得临床推广和应用。Objective To observe the effect of laparoscopic repair of gastric perforation on gastric perforation and its influence on inflammatory factors. Methods The clinical data of 53 patients who underwent laparoscopic gastric perforation repair (observation group) and 52 patients who underwent traditional open gastric perforation repair (control group) in our hospital from February 2016 to March 2018 were retrospectively analyzed. The operation time, intraoperative bleeding volume, time of getting out of bed after operation, average hospitalization time, hospitalization expenses, pain scores at 12, 24, 36, 48, 72 hours after operation, complications, levels of serum CRP, IL-1, IL-6 and TNF-琢before and after treatment were compared between the two groups. Results There were no significant differences in operation time and hospitalization expenses between the two groups (P>0.05). The intraoperative bleeding volume, the time of getting out of bed after operation and the average hospitalization time in the observation group were better than those in the control group (P<0.05). The pain scores of the observation group at 12, 24, 36, 48 and 72 hours after operation were lower than those of the control group, and the differences were statistically significant (P<0.05). The incidence of abdominal abscess, abdominal hemorrhage, adhesive intestinal obstruction and incisional hernia in the observation group were lower than those in the control group (P<0.05). After treatment, the levels of serum CRP, IL-1, IL-6 and TNF-琢in the two groups were lower than those before treatment, and those in the observation group were lower than the control group, the differences were statistically significant (P<0.05). Conclusion Laparoscopic repair of gastric perforation can significantly improve the clinical efficacy of patients with gastric perforation, which is conducive to the recovery of patients. It is worthy of clinical promotion and application.

关 键 词：胃穿孔 腹腔镜 炎症反应 

分 类 号：R656.6[医药卫生—外科学]