胃大部分切除术对老年急性胃穿孔患者胃泌素水平及应激反应的影响  

Effect of Subtotal Gastrectomy on Gastrin Level and Stress Response in Elderly Patients with Acute Gastric Perforation

作　　者：徐宁 陈勇[1] 蔡宁 XU Ning;CHEN Yong;CAI Ning(ⅡWard,Department of General Surgery,Anshun People's Hospital,Anshun,Guizhou,561000,China)

机构地区：[1]安顺市人民医院普外科二病区,贵州安顺561000

出　　处：《中外医疗》2025年第5期40-43,共4页China & Foreign Medical Treatment

摘　　要：目的研究胃大部分切除术对老年急性胃穿孔患者胃泌素水平与应激反应的影响。方法随机选取2021年6月—2023年3月安顺市人民医院收治的200例老年急性胃穿孔患者作为研究对象,将上述患者分为两组进行对比研究,分组标准为所行手术方式的不同,各100例。行单纯修补术的患者被分入对照组,行胃大部分切除术的患者被分入观察组。对比两组患者的临床疗效、围手术期相关指标、胃泌素水平以及应激反应。结果观察组临床治疗总有效率为98.00%(98/100),高于对照组的88.00%(88/100),差异有统计学意义(χ^(2)=7.680,P<0.05)。在围手术期指标方面,对照组的手术时间更短,住院时间更短,术中出血量更少,均优于观察组,差异均有统计学意义(P均<0.05)。术后,观察组患者胃泌素水平低于对照组,差异有统计学意义(P<0.05)。术后,两组应激指标对比,差异无统计学意义(P>0.05)。结论胃大部分切除术能够提升老年急性胃穿孔的临床疗效,且相较于单纯修补术对老年患者术后炎性应激指标水平提升无显著差异,但手术操作较为复杂,手术时间较长。Objective To study the effect of subtotal gastrectomy on gastrin level and stress response in elderly patients with acute gastric perforation.Methods A total of 200 elderly patients with acute gastric perforation admitted to Anshun People's Hospital from June 2021 to March 2023 were randomly selected as the research objects.The above patients were divided into two groups for comparative study.The grouping criteria were different surgical methods,100 cases each.The patients who underwent simple repair were divided into the control group,and the patients who underwent subtotal gastrectomy were divided into the observation group.The clinical efficacy,perioperative related indicators,gastrin level and stress response were compared between the two groups.Results The total clinical effective rate of clinical treatment in the observation group was 98.00%(98/100),which was higher than 88.00%(88/100)of the control group,and the difference was statistically significant(χ^(2)=7.680,P<0.05).In terms of perioperative indicators,the operation time of the control group was shorter,the hospitalization time was shorter,and the intraoperative blood loss was less,which were better than those of the observation group,and the differences were statistically significant(all P<0.05).After operation,the gastrin level in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).After operation,there was no significant difference in stress indexes between the two groups(P>0.05).Conclusion Subtotal gastrectomy can improve the clinical efficacy of acute gastric perforation in the elderly,and there is no significant difference in the level of postoperative inflammatory stress indicators in elderly patients compared with simple repair,but the operation is more complicated and the operation time is longer.

关 键 词：老年急性胃穿孔 胃大部分切除术 胃泌素 应激水平 

分 类 号：R656.6[医药卫生—外科学]