腹腔镜下与开腹修补术治疗胃十二指肠穿孔的效果及对胃肠动力的影响  

The effect of laparoscopic repair and open repair on gastroduodenal perforation and its influence on gastrointestinal motility

作　　者：代雪江 蔡银柜 DAI Xue-jiang;CAI Yin-gui(Department of Gastrointestinal Surgery,Zhongxian County People’s Hospital,Chongqing 404300,China)

机构地区：[1]重庆市忠县人民医院胃肠外科,404300 [2]重庆市黔江中心医院,409000

出　　处：《中国实用医药》2021年第21期31-33,共3页China Practical Medicine

摘　　要：目的比较胃十二指肠穿孔应用腹腔镜下与开腹修补术治疗的效果及对胃肠动力的影响。方法88例接受手术治疗的胃十二指肠穿孔患者为研究对象,按随机数字表法分为对照组及观察组,各44例。对照组行开腹修补术,观察组行腹腔镜下修补术。对比两组患者的手术情况、胃肠动力恢复情况、并发症发生情况、治疗前后的胃肠激素[血浆胃动素(MTL)、血管活性肠肽(VIP)]水平。结果观察组患者的手术时间(4.04±1.12)h、住院时间(4.21±2.24)d短于对照组的(5.95±2.54)h、(7.25±3.28)d,术中出血量(67.41±3.58)ml少于对照组的(140.02±9.46)ml,差异具有统计学意义(P<0.05)。观察组患者的术后排气时间(0.88±0.24)d、胃肠减压时间(1.15±0.25)d、肠鸣音恢复时间(11.75±2.04)min均短于对照组的(1.69±0.44)d、(1.98±0.58)d、(23.48±3.84)min,差异具有统计学意义(P<0.05)。观察组患者的并发症发生率4.55%低于对照组的20.45%,差异具有统计学意义(P<0.05)。治疗后,两组患者的MTL、VIP水平均高于治疗前,且观察组患者的MTL、VIP水平高于对照组,差异具有统计学意义(P<0.05)。结论胃十二指肠穿孔应用腹腔镜下修补术治疗,可有效增强治疗效果,促进胃肠动力恢复。Objective To compare the effect of laparoscopic repair and open repair on gastroduodenal perforation and its influence on gastrointestinal motility.Methods A total of 88 patients with gastroduodenal perforation who underwent surgical treatment as study subjects were divided into control group and observation group according to random numerical table,with 44 cases in each group.The control group was treated with open repair,and the observation group was treated with laparoscopic repair.The surgical status,gastrointestinal motility recovery,occurrence of complications,and gastrointestinal hormones[plasma motilin(MTL),vasoactive intestinal peptide(VIP)]levels before and after treatment were compared between the two groups.Results The operation time(4.04±1.12)h and the hospitalization time(4.21±2.24)d of the observation group were shorter than(5.95±2.54)h and(7.25±3.28)d of the control group,and the intraoperative blood loss(67.41±3.58)ml was less than(140.02±9.46)ml of the control group.All the difference was statistically significant(P<0.05).The postoperative exhaust time(0.88±0.24)d,gastrointestinal decompression time(1.15±0.25)d and bowel sound recovery time(11.75±2.04)min of the observation group were shorter than(1.69±0.44)d,(1.98±0.58)d and(23.48±3.84)min of the control group,and the difference was statistically significant(P<0.05).The complication rate of the observation group was 4.55%,which was lower than 20.45%of the control group,and the difference was statistically significant(P<0.05).After treatment,the MTL and VIP levels of the two groups were higher than those before treatment,and the MTL and VIP levels of the observation group were higher than those of the control group.All the difference was statistically significant(P<0.05).Conclusion The application of laparoscopic repair for gastroduodenal perforation can effectively enhance the therapeutic effect and promote the recovery of gastrointestinal motility.

关 键 词：腹腔镜 开腹修补术 胃十二指肠穿孔 治疗效果 胃肠动力 

分 类 号：R656.6[医药卫生—外科学]