腹腔镜尼龙绳联合双臂钳修补术治疗急性胃穿孔患者的效果  

Effects of laparoscopic nylon rope combined with double arm forceps repair on patients with acute gastric perforation

作　　者：郭俊杰 GUO Junjie(Department of General Surgery of Dalian the Fourth People’s Hospital,Dalian 116033 Liaoning,China)

机构地区：[1]大连市第四人民医院普外科,辽宁大连116033

出　　处：《中国民康医学》2023年第6期52-54,58,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察腹腔镜尼龙绳联合双臂钳修补术治疗急性胃穿孔患者的效果。方法:选取2021年3月至2022年2月该院收治的90例急性胃穿孔患者进行前瞻性研究,按照随机数字表法将其分为观察组和对照组各45例。对照组行开腹修补术治疗,观察组行腹腔镜尼龙绳联合双臂钳修补术治疗。比较两组围术期指标(手术时间、术中出血量、引流管拔除时间、肠鸣音恢复时间、住院时间)水平、术后随访6个月时的临床疗效、术前和术后1 d炎性因子[白细胞介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]水平、术前和术后3 d胃肠激素指标[胃泌素(GAS)、血管活性肠肽(VIP)]水平,以及并发症发生率。结果:观察组手术时间、引流管拔除时间、肠鸣音恢复时间、住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);观察组治疗总有效率为91.11%(41/45),高于对照组的75.56%(34/45),差异有统计学意义(P<0.05);术后,观察组IL-6、CRP、TNF-α、VIP、GAS水平均低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为4.44%(2/45),低于对照组的17.78%(8/45),差异有统计学意义(P<0.05)。结论:腹腔镜尼龙绳联合双臂钳修补术治疗急性胃穿孔患者可降低围术期指标水平和并发症发生率,提高疗效,改善炎性因子和胃肠激素指标水平,效果优于开腹修补术治疗。Objective:To observe effects of laparoscopic nylon rope combined with double arm forceps repair on patients with acute gastric perforation.Methods:A prospective study was conducted on 90 patients with acute gastric perforation admitted to this hospital from March 2021 to February 2022.They were divided into observation group and control group according to the random number table method,45 cases in each.The control group was treated with open repair,while the observation group was treated with laparoscopic nylon rope combined with double arm forceps repair.The levels of perioperative indicators(operation time,intraoperative blood loss,drainage tube removal time,bowel sound recovery time,hospitalization time),the clinical efficacy at 6 months of postoperative follow-up,the levels of inflammatory factors[interleukin-6(IL-6),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)]before and 1 day after the surgery,the levels of gastrointestinal hormones[gastrin(GAS),vasoactive intestinal peptide(VIP)]before and 3 days after the surgery,and the incidence of complications were compared between the two groups.Results:The operation time,the drainage tube removal time,the bowel sound recovery time and the hospitalization time of the observation group were shorter than those of the control group,the intraoperative blood loss was less than that of the control group,and the differences were statistically significant(P<0.05).The total effective rate of treatment in the observation group was 91.11%(41/45),which was higher than 75.56%(34/45)in the control group,and the difference was statistically significant(P<0.05).After the surgery,the levels of IL-6,CRP,TNF-α,VIP and GAS in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Further,the incidence of complications in the observation group was 4.44%(2/45),which was lower than 17.78%(8/45)in the control group,and the difference was statistically significant(P<0.05).Conclusions:Laparoscopic nylon rope com

关 键 词：急性胃穿孔 腹腔镜尼龙绳联合双臂钳修补术 开腹修补术 炎性因子 胃肠激素 并发症 

分 类 号：R656.61[医药卫生—外科学]