腹腔镜修补术与开腹修补术治疗急性胃穿孔的有效性、安全性及复发性对比  

Comparison of the eff ectiveness,safety,and recurrence of laparoscopic repair and open repair in the treatment of acute gastric perforation

作　　者：张奎 陈敬根 Zhang Kui;Chen Jinggen(General Surgery Department of Yunxi County People’s Hospital in Shiyan City,Hubei Shiyan 442600,China)

机构地区：[1]十堰市郧西县人民医院普外科,湖北十堰442600

出　　处：《临床普外科电子杂志》2025年第1期46-49,59,共5页Journal of General Surgery for Clinicians(Electronic Version)

摘　　要：目的比较急性胃穿孔腹腔镜修补术与开腹修补术的治疗效果。方法选取2021年1月至2023年12月十堰市郧西县人民医院收治的100例急性胃穿孔患者,根据随机数字表法分为对照组和观察组,各50例。对照组采用开腹修补术,观察组采用腹腔镜修补术,对比两组治疗的临床效果。结果观察组患者的切口长度短于对照组,术中出血量少于对照组,且手术时间、下床时间、肠鸣音恢复时间、排气时间及住院时间均短于对照组,差异均有显著性(P<0.001)。术前,两组患者的胃肠激素水平、炎症因子水平均无显著差异(P>0.05);术后,观察组患者的血管活性肠肽、胃泌素、胃动素水平高于对照组,白细胞介素-6、肿瘤坏死因子-α、C反应蛋白水平低于对照组,差异均有显著性(P<0.001)。观察组患者的并发症总发生率为2.00%(1/50),复发率为0,均低于对照组[分别为20.00%(10/50)、44.00%(6/50)],差异均有显著性(P<0.05)。结论腹腔镜修补术、开腹修补术均可一定程度上改善急性胃穿孔患者的病情,但是腹腔镜修补术可以减轻对患者身体的创伤,有助于减轻机体炎症反应,降低术后并发症发生率及复发率。Objective To compare the therapeutic eff ects of laparoscopic repair and open repair for acute gas-tric perforation.Method 100 patients with acute gastric perforation admitted to Yunxi County People’s Hospital in Shiyan City from January 2021 to December 2023 were selected and randomly divided into two groups of 50 each using a random number table method.The control group underwent open abdominal repair surgery,while the obser-vation group underwent laparoscopic repair surgery.The clinical eff ects of the two groups were compared.Result The incision length of the observation group patients was shorter than that of the control group,the intraoperative blood loss was less than that of the control group,and the operation time,bed getting time,bowel sound recovery time,exhaust time,and hospitalization time were all shorter than those of the control group,with signifi cant dif-ferences(P<0.001).Before surgery,there was no signifi cant diff erence in the levels of gastrointestinal hormones and infl ammatory factors between the two groups of patients(P>0.05);After surgery,the levels of vasoactive intestinal peptide,gastrin,and motilin in the observation group were higher than those in the control group,while the levels of interleukin-6,tumor necrosis factor-α,and C-reactive protein were lower than those in the control group,with signifi cant diff erences(P<0.001).The total incidence of complications in the observation group was 2.00%(1/50),and the recurrence rate was 0,both lower than those in the control group[20.00%(10/50),44.00%(6/50),respectively],with signifi cant diff erences(P<0.05).Conclusion Laparoscopic repair and open repair can both improve the condition of patients with acute gastric perforation to a certain extent.However,laparoscopic re-pair can reduce the trauma to the patient’s body,help alleviate the body’s infl ammatory response and lower the incidence of postoperative complications and recurrence.

关 键 词：急性胃穿孔 腹腔镜修补术 开腹修补术 炎症反应 胃肠激素 并发症 

分 类 号：R65[医药卫生—外科学]