开腹手术与腹腔镜下消化道穿孔修补术治疗上消化道溃疡穿孔的效果对比  

Comparison of the effect of open surgery and laparoscopic peptic perforation repair in the treatment of upper gastrointestinal tract ulcer perforation

作　　者：吴胜伟 陈龙林 林晓荣 WU Sheng-wei;CHEN Long-lin;LIN Xiao-rong(Department of General Surgery,Shantou Dafeng Hospital,Shantou 515154,China)

机构地区：[1]汕头市大峰医院普外科,515154

出　　处：《中国现代药物应用》2023年第14期1-6,共6页Chinese Journal of Modern Drug Application

摘　　要：目的对比上消化道溃疡穿孔患者应用开腹手术与腹腔镜下消化道穿孔修补术治疗的临床效果。方法75例上消化道溃疡穿孔患者,按照随机数字表法分为常规组(37例)和研究组(38例)。常规组患者实施开腹手术治疗,研究组患者实施腹腔镜下消化道穿孔修补术治疗。对比两组患者并发症发生情况,手术指标,疼痛评分,治疗前后生活质量评分,治疗前后炎性因子水平,治疗前后胃肠激素水平,治疗前后睡眠质量评分,治疗前后舒适度评分。结果研究组并发症发生率5.26%低于常规组的21.62%,差异具有统计学意义(P<0.05)。研究组患者手术时间(70.67±3.26)min、排气时间(24.32±1.23)h、排便时间(41.23±1.33)h、住院时间(7.93±1.23)d均短于常规组的(88.68±3.28)min、(40.35±1.43)h、(66.48±1.44)h、(12.26±1.24)d,术中出血量(20.27±2.33)ml和术后引流量(124.26±12.12)ml均少于常规组的(37.22±2.32)、(163.48±12.16)ml,差异具有统计学意义(P<0.05)。研究组术后1、3、7、15 d疼痛评分分别为(7.17±0.16)、(5.21±0.13)、(3.16±0.15)、(0.52±0.13)分,均低于常规组的(7.88±0.18)、(6.23±0.12)、(4.58±0.14)、(2.31±0.15)分,差异具有统计学意义(P<0.05)。治疗后,研究组躯体健康、社会功能、人际交往、工作生活评分分别为(96.43±1.31)、(85.34±1.22)、(95.34±1.25)、(88.34±1.21)分,均高于常规组的(91.21±1.32)、(75.34±1.21)、(86.34±1.25)、(75.31±1.23)分,差异具有统计学意义(P<0.05)。治疗后,研究组超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)分别为(3.56±1.22)mg/L、(10.34±1.22)pg/ml、(0.82±0.25)ng/L,均低于常规组的(5.76±1.24)mg/L、(13.25±1.13)pg/ml、(1.23±0.21)ng/L,差异具有统计学意义(P<0.05)。治疗后,研究组胃泌素17(G-17)、胃动素(MTL)、胃蛋白酶Ⅰ(PGⅠ)分别为(26.32±1.37)ng/L、(134.24±9.29)ng/L、(107.31±8.27)μg/L,均高于常规组的(22.33±1.35)ng/L、(114.26±9.31)ng/L、(93Objective To compare the clinical effect of open surgery and laparoscopic peptic perforation repair in the treatment of upper gastrointestinal tract ulcer perforation.Methods A total of 75 patients with upper gastrointestinal tract ulcer perforation were divided into a conventional group(37 cases)and a research group(38 cases)according to the random numerical table.Patients in the conventional group were treated with open surgery,and patients in the research group were treated with laparoscopic peptic perforation repair.Both groups were compared in terms of complications,surgical indicators,pain score,quality of life scores before and after treatment,inflammatory factor levels before and after treatment,gastrointestinal hormone levels before and after treatment,sleep quality scores before and after treatment,and comfort scores before and after treatment.Results The complication rate of 5.26%in the research group was lower than that of 21.62%in the conventional group,and the difference was statistically significant(P<0.05).The research group had operative time of(70.67±3.26)min,exhaust time of(24.32±1.23)h,defecation time of(41.23±1.33)h,and hospitalization time of(7.93±1.23)d,which were shorter than those of(88.68±3.28)min,(40.35±1.43)h,(66.48±1.44)h,and(12.26±1.24)d in the conventional group;the intraoperative blood loss of(20.27±2.33)ml and postoperative drainage volume of(124.26±12.12)ml in the research group were less than those of(37.22±2.32)and(163.48±12.16)ml in the conventional group;the differences were statistically significant(P<0.05).The pain scores at 1,3,7 and 15 d postoperatively were(7.17±0.16),(5.21±0.13),(3.16±0.15)and(0.52±0.13)points in the research group,which were lower than those of(7.88±0.18),(6.23±0.12),(4.58±0.14)and(2.31±0.15)points in the conventional group,and the differences were statistically significant(P<0.05).After treatment,the scores of physical health,social function,interpersonal communication and work life were(96.43±1.31),(85.34±1.22),(95.34±1.25)and(

关 键 词：开腹手术 腹腔镜下消化道穿孔修补术 上消化道溃疡穿孔 效果对比 

分 类 号：R656[医药卫生—外科学]