腹腔镜下修补术治疗胃十二指肠溃疡急性穿孔的效果及对免疫功能、氧化应激水平的影响  

Effect of laparoscopic repair on acute perforation of gastroduodenal ulcer and its influences on immune function and oxidative stress level

作　　者：富裕 陈文龙 FU Yu;CHEN Wenlong(No.1 General Surgery Department,the First Hospital in Weinan,Weinan 714000,China)

机构地区：[1]渭南市第一医院普外一科,陕西渭南714000

出　　处：《临床医学研究与实践》2024年第25期78-81,共4页Clinical Research and Practice

摘　　要：目的探讨腹腔镜下修补术治疗胃十二指肠溃疡急性穿孔的效果及对免疫功能、氧化应激水平的影响。方法选取2020年1月至2023年1月我院收治的68例胃十二指肠溃疡急性穿孔患者,以随机数字表法将其分为对照组(34例)和观察组(34例)。对照组采用传统开腹手术,观察组采用腹腔镜下修补术。比较两组的手术效果。结果观察组的手术时间、住院时间、肠功能恢复时间及肛门排气时间短于对照组,术中出血量少于对照组(P<0.05)。治疗后,两组的胃蛋白酶原Ⅰ(PGⅠ)、胃泌素-17(G-17)水平降低,且观察组低于对照组(P<0.05)。治疗后,观察组的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于对照组,CD8^(+)低于对照组(P<0.05)。治疗后,观察组的皮质醇(Cor)、去甲肾上腺素(NE)及促血管生成素-Ⅱ(Ang-Ⅱ)水平低于对照组(P<0.05)。观察组的并发症总发生率为5.88%,低于对照组的26.47%(P<0.05)。结论腹腔镜下修补术治疗胃十二指肠溃疡急性穿孔患者的效果显著,可促进术后恢复,减轻氧化应激反应,改善免疫功能,且术后并发症少。Objective To investigate the effect of laparoscopic repair on acute perforation of gastroduodenal ulcer and its influences on immune function and oxidative stress level.Methods A total of 68 patients with acute perforation of gastroduodenal ulcer admitted in our hospital from January 2020 to January 2023 were selected and divided into control group(34 cases)and observation group(34 cases)by random number table method.The control group was treated with traditional open surgery,and the observation group was treated with laparoscopic repair.The surgical effects of the two groups were compared.Results The operation time,hospitalization time,intestinal function recovery time and anal exhaust time were shorter than those of the control group,and the intraoperative blood loss was less than that of the control group(P<0.05).After treatment,the levels of pepsinogenⅠ(PGⅠ)and gastrin-17(G-17)in the two groups decreased,and those in the observation group were lower than the control group(P<0.05).After treatment,CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the observation group were higher than those in the control group,and CD8^(+)was lower than that in the control group(P<0.05).After treatment,the levels of cortisol(Cor),norepinephrine(NE)and angiopoietin-Ⅱ(Ang-Ⅱ)in the observation group were lower than those in the control group(P<0.05).The total incidence of complications in the observation group was 5.88%,which was lower than 26.47%in the control group(P<0.05).Conclusion Laparoscopic repair has a significant effect on patients with acute perforation of gastroduodenal ulcer,which can promote postoperative recovery,reduce oxidative stress response,improve immune function,and has fewer postoperative complications.

关 键 词：腹腔镜下修补术 胃十二指肠溃疡 免疫功能 氧化应激 

分 类 号：R656.6[医药卫生—外科学]