腹腔镜及开腹修补术对胃溃疡穿孔患者术后胃肠功能及肠黏膜屏障的影响比较  

Comparison on the Influence of Laparoscopic and Open Gastric Perforation Repair for Postoperative Gastrointestinal Function and Intestinal Mucosal Barrier in Patients with Perforation of Gastric Ulcer

作　　者：罗苏青 王凯 徐德华 LUO Suqing;WANG Kai;XU Dehua(Suzhou Xiangcheng People’s Hospital,Suzhou 215131,China)

机构地区：[1]苏州相城人民医院,江苏苏州215131

出　　处：《中外医学研究》2022年第19期44-47,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨及比较腹腔镜及开腹修补术对胃溃疡穿孔患者术后胃肠功能及肠黏膜屏障的影响。方法:选取2019年1月-2021年12月的100例胃溃疡穿孔手术患者为研究对象,将其随机分为对照组和观察组,各50例。对照组进行开腹胃穿孔修补术治疗,观察组则进行腹腔镜胃穿孔修补术治疗。比较两组术后的胃肠功能恢复时间、并发症发生率、手术前后的胃肠激素[血管活性肠肽(VIP)、胃泌素(GAS)及胃动素(MTL)]及肠黏膜屏障指标[二胺氧化酶(DAO)、内毒素(ET)、一氧化氮(NO)及D-乳酸(D-Lac)]水平。结果:观察组的胃肠功能恢复时间显著优于对照组,差异有统计学意义(P<0.05)。两组的并发症发生率比较,差异无统计学意义(P>0.05)。术前两组的胃肠激素及肠黏膜屏障指标比较,差异无统计学意义(P>0.05);术后3、7 d,观察组的胃肠激素指标先降后升,且均显著高于对照组,肠黏膜屏障指标则先升后降,且均显著低于对照组,差异均有统计学意义(P<0.05)。结论:腹腔镜修补术对胃溃疡穿孔患者术后胃肠功能及肠黏膜屏障的不良影响显著小于开腹修补术,因此腹腔镜修补术在胃溃疡穿孔患者中的应用价值较高。Objective:To investigate and compared the influence of laparoscopic and open gastric perforation repair for postoperative gastrointestinal function and intestinal mucosal barrier in patients with perforation of gastric ulcer.Method:A total of 100 surgical patients with perforation of gastric ulcer from January 2019 to December 2021 were chosen as the study object,and they were randomly divided into control group and observation group,with 50 cases in each group.The control group was treated with open gastric perforation repair,while the observation group was treated with laparoscopic gastric perforation repair.And the recovery time of gastrointestinal function,complications rates,levels of gastrointestinal hormones[vasoactive intestinal peptide (VIP),gastrin (GAS) and motilin (MTL)]and intestinal mucosal barrier indexes[diamine oxidase (DAO),endotoxin (ET),nitric oxide (NO) and D-lactic acid (D-Lac)]before and after operation of two groups were compared.Result:The recovery time indexes of gastrointestinal function of observation group were significantly better than those of control group,the differences were statistically significant (P<0.05).The complications rate of two groups was compared,the difference was not statistically significant (P>0.05).There were no significant differences in gastrointestinal hormones and intestinal mucosal barrier indexes between the two groups before surgery (P>0.05);at 3 d and 7 d after surgery,gastrointestinal hormones in the observation group decreased first and then increased,and which were significantly higher than those in the control group,while intestinal mucosal barrier indexes increased first and then decreased,and which were significantly lower than those in the control group,the differences were statistically significant (P<0.05).Conclusion:The bad influence of laparoscopic gastric perforation repair for postoperative gastrointestinal function and intestinal mucosal barrier of patients with perforation of gastric ulcer are smaller than those of open gastric perforation

关 键 词：腹腔镜修补术 开腹修补术 胃溃疡穿孔 胃肠功能 肠黏膜屏障 

分 类 号：R656.62[医药卫生—外科学]