腹腔镜探查术用于腹部多脏器性损伤的临床诊治中对创伤程度及应激反应的影响  

Effects of laparoscopic exploration on trauma degree and stress response in the clinical diagnosis and treatment of abdominal multiple organ injuries

作　　者：吴天杭 徐信业 WU Tianhang;XU Xinye(Ankang Hospital of Traditional Chinese Medicine,Ankang 725000,China)

机构地区：[1]安康市中医医院,陕西安康725000

出　　处：《临床医学研究与实践》2021年第3期75-77,共3页Clinical Research and Practice

摘　　要：目的探讨腹腔镜探查术用于腹部多脏器性损伤的临床诊治中对创伤程度及应激反应的影响。方法选取2017年1月至2020年1月收治的200例腹部多脏器损伤患者作为研究对象,根据随机数字法将其分为对照组和观察组,各100例。对照组采用剖腹探查术进行诊治,观察组采用腹腔镜探查术进行诊治。比较两组患者的创伤程度、应激反应指标、并发症发生情况及术后恢复情况。结果观察组的切口长度显著短于对照组,术中出血量显著少于对照组,术后视觉模拟评分法(VAS)评分显著低于对照组(P<0.05)。术中、术后1 h,观察组的去甲肾上腺素(NE)、皮质醇(Cor)及血管紧张素Ⅱ(AngⅡ)水平均显著低于对照组(P<0.05)。观察组的并发症总发生率为2.13%,低于对照组的11.00%(P<0.05)。观察组的术后排气时间、首次下床时间及住院时间均明显短于对照组(P<0.05)。结论腹腔镜探查术应用在腹部多脏器性损伤诊治中,能够减小创伤程度,减轻机体应激反应,降低并发症发生率,促进患者术后快速恢复,值得推广。Objective To explore the effects of laparoscopic exploration on trauma degree and stress response in the clinical diagnosis and treatment of abdominal multiple organ injuries.Methods A total of 200 patients with abdominal multiple organ injuries admitted from January 2017 to January 2020 were selected as the research objects and divided into control group and observation group by random number method,with 100 cases in each group.The control group was diagnosed and treated by laparotomy exploration,and the observation group was diagnosed and treated by laparoscopic exploration.The degree of trauma,stress response indexes,the occurrence of complications and postoperative recovery of the two groups were compared.Results The incision length of the observation group was significantly shorter than that of the control group,the intraoperative blood loss volume was significantly less than that of the control group,and the postoperative visual analogue scale(VAS)score was significantly lower than that of the control group(P<0.05).During operation and 1 h after operation,the levels of norepinephrine(NE),cortisol(Cor)and angiotensinⅡ(AngⅡ)in the observation group were significantly lower than those in the control group(P<0.05).The total incidence of complications in the observation group was 2.13%,which was lower than 11.00%in the control group(P<0.05).The postoperative exhaust time,first time out of bed time and hospitalization time of the observation group were significantly shorter than those of the control group(P<0.05).Conclusion The laparoscopic exploration applied in the diagnosis and treatment of abdominal multiple organ injuries can reduce the degree of trauma,alleviate the body’s stress response,reduce the incidence of complications,and promote the rapid recovery of patients after surgery,which is worthy of promotion.

关 键 词：腹腔镜探查术 腹部多脏器性损伤 临床诊治 创伤程度 应激反应 

分 类 号：R656[医药卫生—外科学]