腹腔镜胃修补术治疗急性胃穿孔患者的效果  

Effects of laparoscopic gastrorrhaphy in treatment of patients with acute gastric perforation

作　　者：马超 张帅 赵勇[1] MA Chao;ZHANG Shuai;ZHAO Yong(Department of Surgery of West District Hospital of Nanyang First People’s Hospital,Nanyang 473000 Henan,China)

机构地区：[1]南阳市第一人民医院西区医院外科,河南南阳473000

出　　处：《中国民康医学》2024年第16期48-51,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察腹腔镜胃修补术治疗急性胃穿孔患者的效果。方法:回顾性分析2021年8月至2023年8月该院收治的102例急性胃穿孔患者的临床资料,依据手术方法不同将其分为观察组(n=51)和对照组(n=51)。观察组行腹腔镜胃修补术治疗,对照组行开腹胃修补术治疗,比较两组围术期指标水平,手术前后胃肠激素指标[胃泌素(GAS)、胃蛋白酶原(PG)Ⅰ、PGⅡ、胃动素(MTL)]水平、炎性应激因子[白细胞介素-8(IL-8)、去甲肾上腺素(NE)、前列腺素E_(2)(PGE_(2))、C反应蛋白(CRP)]水平、疼痛程度[视觉模拟评分法(VAS)]评分,以及术后1周并发症发生率。结果:观察组手术时间、住院时间、首次排气时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);术后3 d,观察组GAS、PGⅠ、MTL和PGⅡ水平均高于对照组,差异有统计学意义(P<0.05);术后3 d,观察组IL-8、NE、CRP和PGE_(2)水平均低于对照组,差异有统计学意义(P<0.05);术后1、3 d,观察组VAS评分均低于对照组,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:腹腔镜胃修补术治疗急性胃穿孔患者可提高胃肠激素指标水平,降低围术期指标水平、炎性应激因子水平和疼痛程度评分,效果优于开腹胃修补术治疗。Objective:To observe effects of laparoscopic gastrorrhaphy in treatment of patients with acute gastric perforation.Methods:The clinical data of 102 patients with acute gastric perforation admitted to this hospital from August 2021 to August 2023 were retrospectively analyzed.According to different surgical methods,they were divided into observation group(n=51)and control group(n=51).The observation group was treated with laparoscopic gastrorrhaphy,while the control group was treated with open gastrorrhaphy.The perioperative index levels,the gastrointestinal hormone indexes[gastrin(GAS),pepsinogen(PG)I,PGII,motilin(MTL)]levels,the inflammatory stress factors[interleukin-8(IL-8),norepinephrine(NE),prostaglandin E_(2)(PGE_(2)),C-reactive protein(CRP)]levels,the pain degree[visual analogue scale(VAS)]score before and after surgery,and the incidence of complications 1 week after the surgery were compared between the two groups.Results:The operation time,the hospitalization time and the first exhaust 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).Three days after the surgery,the levels of GAS,PGI,MTL and PGII in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Three days after the surgery,the levels of IL-8,NE,CRP and PGE_(2) in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).One and 3 days after the surgery,the VAS scores of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusions:Laparoscopic gastrorrhaphy for the patients with acute gastric perforation can improve the levels of gastrointestinal hormones and reduce the levels of

关 键 词：腹腔镜胃修补术 开腹胃修补术 急性胃穿孔 胃肠激素 炎性应激因子 疼痛 并发症 

分 类 号：R573[医药卫生—消化系统]