腹腔镜胃肠穿孔修补术对患者胃肠动力恢复及胃肠激素的影响

The impact of laparoscopic gastrointestinal perforation repair on gastrointestinal motility and gastrointestinal hormones

目的 探讨腹腔镜胃肠穿孔修补术对患者胃肠动力恢复及胃肠激素的影响.方法 将2013年6月～2014年1月行腹腔镜胃肠穿孔修补术患者30例,设立为腹腔镜组,另选择同期行传统开腹胃十二指肠穿孔修补术患者32例,设立为对照组,比较腹腔镜组及对照组手术时间、术中出血量、术后住院时间及胃肠动力恢复指标包括术后肛门排气时间、肠鸣音恢复时间、胃肠减压解除时间及术前术后血浆MTL和VIP水平的变化情况.结果 腹腔镜组与对照组患者的手术时间比较,差异无统计学意义,但腹腔镜组的术中出血量明显少于对照组,而腹腔镜组术后住院时间短于对照组,差异有统计学意义（P＜0.05）.腹腔镜组患者的术后肛门排气时间、肠鸣音恢复时间、胃肠减压解除时间均短于对照组,差异有统计学意义（P＜0.05）.腹腔镜组与对照组患者术前MTL和VIP水平分别比较,差异无统计学意义（P＞0.05）.术后腹腔镜组与对照组患者的MTL和VIP水平分别较术前显著提高,且腹腔镜组患者的MTL和VIP水平均分别显著高于对照组,差异有统计学意义（P＜0.05）.结论 腹腔镜胃肠穿孔修补术具有出血少、患者术后胃肠功能恢复快等优点,考虑可能与其提高胃肠激素水平有关.

Objective To investigate the impact of laparoscopic gastrointestinal perforation repair on gastrointestinal motility and gastrointestinal hormones. Methods From June 2013 to January 2014, seleceted laparoscopic repair of gastrointestinal perforation in 30 patients, set up for the laparoscopic group, and the other 32 patients with concomitant traditional open surgery in patients with gastroduodenal perforation repair establishment for the control group,the opera- tive time, blood loss,postoperative hospital stay and recovery of gastrointestinal motility indicators include anal exhaust time, recovery time of bowel sounds, time and decompression released preoperative and postoperative changes in plas- ma levels of MTL and VIP were compared between laparoscopic group and the control group. Results The operative time of laparoscopic group compared with the control group, the difference was not significant, but the blood loss of the laparoscopic group was significantly less than the control group , and shorter hospital stay of laparoscopic group than the control group,the difference was significant（P〈0.05）.The anal exhaust time, recovery time of bowel sounds, lifting de- compression times of laparoscopic group of patients was shorter than the control group,the difference was significant （P〈0.05）. The preoperative level of MTL and VIP patients in the laparoscopic group compared with control group, the difference was not significant （P〉0.05）. MTL and VIP levels of the laparoscopic group and control group compared with before surgery were significantly improved, and MTL and VIP levels of the laparoscopic group were significantly higher than the control group,the difference was significant（P〈0.05）. Conclusion Laparoscopic repair of gastrointestinal perforation have less bleeding, postoperative gastrointestinal function and quick recovery, considering the possibility to improve their gastrointestinal hormone levels.