倒刺线在经脐单孔腹腔镜穿孔修补术治疗老年胃十二指肠溃疡穿孔的疗效分析及对肠道屏障功能的影响  

Curative Effect Analysis of Barbed Suture in Transumbilical Single Hole Laparoscopic Gastric Duodenal Perforation Repair Surgery in the Treatment for Elderly Gastric and Duodenal Ulcer Perforation and its Effect on Intestinal Barrier Function

作　　者：何志威 刘心洋 周志球 林晓华 利民 HE Zhi-wei;LIU Xin-yang;ZHOU Zhi-qiu;LIN Xiao-hua;LI Min(Department of General Surgery,Dongguan Shilong People's Hospital Affiliated to Southern Medical University,Dongguan,Guangdong,523326,China;Department of General Surgery,Nan fang Hospital of Southern Medical University,Guangzhou,Guangdong,510515,China)

机构地区：[1]南方医科大学附属东莞石龙人民医院普通外科,广东东莞523326 [2]南方医科大学南方医院普外科,广东广州510515

出　　处：《现代生物医学进展》2022年第1期122-125,135,共5页Progress in Modern Biomedicine

基　　金：广东省东莞市社会科技发展项目(201950715024107);国家自然科学基金项目(81172383)。

摘　　要：目的:探讨倒刺线在经脐单孔腹腔镜胃十二指肠溃疡穿孔修补术中治疗老年患者的临床效果及对肠道屏障功能的影响。方法:回顾性分析南方医科大学附属东莞石龙人民医院收治的行经脐单孔腹腔镜穿孔修补术的老年胃十二指肠溃疡穿孔患者108例的临床资料,按照穿孔缝线的不同分为两组,对照组采用普通可吸收缝线修补穿孔(n=57例),观察组采用倒刺线缝合修补穿孔(n=51例)。比较两组手术指标、术后恢复指标、疼痛指标、术后1个月并发症的发生情况、肠道屏障功能指标的变化。结果:观察组较对照组穿孔缝合时间和手术时间明显缩短(P<0.05),但两组术中出血量、住院时间、肠蠕动恢复时间、肛门恢复排气时间、术后疼痛和并发症发生率比较无统计学差异(P>0.05)。对照组术后肠道屏障功能指标血浆D-乳酸(D-Lac)、二胺氧化酶(DAO)均高于观察组(P<0.05)。结论:经脐单孔腹腔镜穿孔修补术使用倒刺线缝合老年胃十二指肠溃疡穿孔患者,能够一定程度降低腹腔镜下穿孔的缝合难度,并且可显著减少缝合和手术时间,从而加快肠道功能恢复,提高术后康复效率。Objective: To investigate the clinical effect of barbed suture in transumbilical single hole laparoscopic gastric duodenal perforation repair surgery in the treatment for elderly patients and its effect on intestinal barrier function. Methods: The clinical data of108 elderly patients with gastric duodenal perforation who were treated by transumbilical single hole laparoscopic gastric duodenal perforation repair surgeryr in Dongguan Shilong People’s Hospital Affiliated to Southern Medical University were analyzed retrospectively. They were divided into two groups according to different perforation sutures. The control group used ordinary absorbable sutures to repair perforation(n=57 cases), and the observation group used barbed suture to repair perforation(n=51 cases). The changes of operation indexes, postoperative recovery indexes, pain indexes, complications at 1 month after operation and intestinal barrier function indexes were compared between the two groups. Results: The perforation suture time and operation time in the observation group were significantly shorter than those in the control group(P<0.05), but there were no significant differences in intraoperative bleeding, hospital stay, recovery time of intestinal peristalsis, recovery and exhaust time of anus, postoperative pain and incidence of complications between the two groups(P>0.05). The postoperative intestinal barrier function indexes of plasma D-lactic acid(D-Lac) and diamine oxidase(DAO) in the control group were higher than those in the observation group(P<0.05). Conclusion: Transumbilical single hole laparoscopic gastric duodenal perforation repair surgery using barbed suture to suture elderly patients with gastric duodenal perforation can reduce the suture difficulty of laparoscopic perforation to a certain exte nt, and can significantly reduce the suture and operation time, so as to accelerate the recovery of intestinal function, and improve the efficiency of postoperative rehabilitation.

关 键 词：倒刺缝线 经脐单孔腹腔镜穿孔修补术 老年 胃十二指肠溃疡穿孔 临床疗效 肠道屏障功能 

分 类 号：R656.62[医药卫生—外科学]