腹腔镜下穿孔修补术治疗急性胃溃疡穿孔的效果  

Clinical analysis of the efficacy of laparoscopic gastric perforation surgery in treatment of acute gastric ulcer induced gastric perforation

作　　者：卫军要 张庆林 张营 滕智勇 郭白银 宋予军 WEI Junyao;ZHANG Qinglin;ZHANG Ying;TENG Zhiyong;GUO Baiyin;SONG Yujun(Department of General Surgery,the 989th Hospital of the Joint Logistics Support Force of the People's Liberation Army of China,Pingdingshan,Henan,476000,China)

机构地区：[1]中国人民解放军联勤保障部队第九八九医院普通外科,河南平顶山476000

出　　处：《新疆医学》2024年第10期1208-1211,共4页Xinjiang Medical Journal

摘　　要：目的探析腹腔镜下穿孔修补术治疗急性胃溃疡穿孔的效果。方法在2019年10月至2023年6月时段本院收治的急性胃溃疡穿孔患者中选取84例配合研究,依据治疗方法不同分2组,42例/组。对照组采用开腹手术,观察组采用腹腔镜下穿孔修补术治疗。比较两组血清炎性应激指标、胃肠功能指标及并发症发生率。结果两组治疗前血清炎性应激指标水平比较无差异(P>0.05),观察组治疗后IL-1β、PCT及IL-10水平低于对照组,组间差异显著(P<0.05),两组治疗前胃肠功能指标水平比较无差异(P>0.05),观察组治疗后胃动素(MTL)、胃泌素(GAS)水平高于对照组,组间差异显著(P<0.05),治疗后观察组VEGF、EGF、TGF-α以及NO较对照组高,组间差异显著(P<0.05)。观察组并发症发生率4.76%低于对照组的21.43%,组间差异显著(P<0.05)。结论急性胃溃疡穿孔患者采用腹腔镜下穿孔修补术治疗效果明显,患者机体应激水平减轻,其胃肠功能指标水平趋于正常水平,防止患者发生并发症,临床上可借鉴及推广。Objective To explore the therapeutic effect of laparoscopic gastric ulcer perforation repair surgery on acute gastric ulcer induced perforation.Methods 84 patients with acute gastric ulcer induced perforation admitted to our hospital from October 2019 to June 2023 were selected.All cases were divided into control group and observation group based on different treatment methods,with 42 cases in each group.The control group underwent open gastric perforation surgery,while the observation group underwent laparoscopic gastric perforation repair surgery.Serum inflammatory stress indicators,gastrointestinal function indicators,and incidence of complications between two groups were compared.Results There were no significant differences in the levels of serum inflammatory stress indicators between the two groups before treatment(P>0.05).The levels of IL-1β,PCT,and IL-10 in the observation group were lower than those in the control group,with significant differences(P<0.05).The levels of motilin(MTL)and gastrin(GAS)in the observation group were higher than those in the control group(P<0.05).The levels of VEGF,EGF,TGF-α,and NO in the observation group were higher than those in the control group(P<0.05).The incidence of complications in the observation group was 4.76%which was lower than 21.43%in the control group(P<0.05).Conclusion Laparoscopic perforation repair surgery for patients with acute gastric ulcer perforation shows significant therapeutic effects,reducing the patients'stress levels and normalizing gastrointestinal function indicators.This approach helps prevent complications and can be referenced and promoted in clinical practice.

关 键 词：急性胃溃疡穿孔 腹腔镜下穿孔修补术 血管内皮指标 胃肠功能指标 

分 类 号：R656.62[医药卫生—外科学]