腹腔镜胃穿孔修补术联合质子泵抑制剂对胃溃疡穿孔患者血清胃泌素、胃电参数及炎性状态的影响  

Effect of Laparoscopic Repair of Gastric Perforation Combined with Proton Pump Inhibitors on Gastrin,Gastric Electrical Parameters and Inflammatory State in Patients with Gastric Ulcer Perforation

作　　者：桂文波 刘明星 钟斌 GUI Wen-bo;LIU Ming-xing;ZHONG Bin(Department of Abdominal Surgery,Yongzhou Third People's Hospital,Yongzhou,Hunan,425000,China)

机构地区：[1]永州市第三人民医院腹部外科,湖南永州425000

出　　处：《中国血液流变学杂志》2024年第1期77-81,167,共6页Chinese Journal of Hemorheology

摘　　要：目的分析腹腔镜胃穿孔修补术联合质子泵抑制剂(PPI)对胃溃疡穿孔患者胃泌素、胃电参数及炎性状态的影响。方法选取2017年4月—2022年4月永州市第三人民医院收治的140例胃溃疡穿孔患者,按照治疗方法的差异分为研究组和对照组,各70例。两组患者均行腹腔镜胃肠穿孔修补术,术后研究组患者增用PPI,对比两组患者术后指标以及手术前后胃泌素、胃电参数、胃黏膜屏障功能和炎性状态。结果研究组术后肠鸣音恢复时间、肛门排气时间和拔管时间均早于对照组(P<0.05)。手术后,两组胃动素水平较手术前升高,且研究组高于对照组(P<0.05),两组胃泌素水平较手术前降低,且研究组低于对照组(P<0.05)。手术后,两组胃电幅值、正常慢波节律比、胃电频率和胃电主功率均较手术前升高,且研究组高于对照组(P<0.05)。手术后,两组VEGF、TGF-β水平较手术前升高,且研究组高于对照组(P<0.05),两组黏膜厚度评分、腺体密度评分较手术前降低,且研究组低于对照组(P<0.05)。手术后,两组CRP、TNF-α水平较手术前降低,且研究组低于对照组(P<0.05),两组IL-8水平较手术前升高,且研究组高于对照组(P<0.05)。结论腹腔镜胃穿孔修补术联合PPI在胃溃疡穿孔中的效果显著,不仅利于患者术后胃肠功能恢复,还可减轻胃窦部损伤,改善胃黏膜屏障功能,减轻炎症反应。Objective To analyze the effects of laparoscopic repair of gastric perforation combined with proton pump inhibitor(PPI)on gastrin,gastric electrical parameters and inflammatory state in patients with gastric ulcer perforation.Methods 140 patients with gastric ulcer perforation who were admitted to Yongzhou Third People's Hospital from April 2017 to April 2022 were divided into study group and control group according to the difference in treatment methods,70 cases in each group.Laparoscopic repair of gastrointestinal perforation was performed in both groups.Patients in the postoperative study group were additionally treated with PPI.The postoperative indexes of patients in the two groups as well as gastrin,gastric electrical parameters,gastric mucosal barrier function and inflammatory state before and after the operation were compared.Results The recovery time of borborygmus,the time of anal exhaust and the time of extubation in the study group were earlier than those in the control group(P<0.05).After surgery,motilin level in the two groups was higher than that before surgery and higher in the study group than that in the control group(P<0.05).Gastrin level in the two groups was lower than that before surgery and lower in the study group than that in the control group(P<0.05).After surgery,gastric electrical amplitude,normal slow-wave rhythm ratio,gastric electrical frequency,and main gastric electrical power in the two groups were higher than those before surgery,and those in the study group were higher than those in the control group(P<0.05).After surgery,the levels of VEGF and TGF-βin the two groups were higher than those before surgery and higher in the study group than in the control group(P<0.05).The mucosal thickness score and glandular density score in the two groups were lower than those before surgery and lower in the study group than in the control group(P<0.05).After surgery,the levels of CRP and TNF-αin the two groups were lower than those before surgery and were lower in the study group than those

关 键 词：胃溃疡穿孔 腹腔镜胃穿孔修补术 质子泵抑制剂 胃泌素 胃电参数 炎性状态 

分 类 号：R656.62[医药卫生—外科学]