腹腔镜胃穿孔修补术对急性胃穿孔患者术后胃肠功能及生活质量的影响

Effect of Laparoscopic Repair of Gastric Perforation on Gastrointestinal Function and Quality of Life in Patients with Acute Gastric Perforation after Operation

目的研究腹腔镜胃穿孔修补术对急性胃穿孔患者术后胃肠功能及生活质量的影响。方法选取本院急性胃穿孔患者64例,按治疗方案不同分组,各32例。对照组给予开腹胃穿孔修补术,观察组给予腹腔镜胃穿孔修补术。比较两组手术情况(手术时长、失血量)、术后胃肠功能恢复情况[排气时间、肠鸣音恢复时间及术后1d、术后2d血清胃泌素(GAS)含量]、手术前后生活质量(SF-36)评分。结果两组手术时长比较,无显著差异(P>0.05);观察组失血量、排气时间、肠鸣音恢复时间低于对照组,术后1d、术后2d GAS含量高于对照组,差异有统计学意义(P<0.05);手术前,两组SF-36评分比较,无显著差异(P>0.05);观察组术后SF-36评分高于对照组,差异有统计学意义(P<0.05)。结论腹腔镜胃穿孔修补术应用于急性胃穿孔患者可缩短手术时长,减少失血量,缩短术后排气时间、肠鸣音恢复时间,促进胃肠功能恢复,提高生活质量。

Objective To investigate the effect of laparoscopic repair of gastric perforation on gastrointestinal function and quality of life in patients with acute gastric perforation after operation. Methods 64 cases of acute gastric perforation in our hospital were selected and divided into 2 groups according to different treatment schemes, each with 32 cases. The control group was given open repair of gastric perforation, and the observation group was given laparoscopic repair of gastric perforation. Compare the surgery status（surgical duration, intraoperative blood loss）, postoperative recovery of gastrointestinal function（postoperative exhaust time, bowel sound recovery time and postoperative serum gastrin（GAS） content for 1 d and 2 d）, the quality of life（SF-36） score of two groups before and after surgery. Results There was insignificant difference in the length of operation between the two groups（P〉0.05）. The blood loss during operation, postoperative exhaust time and recovery time of bowel sound of the observation group were lower than those of the control group, and the postoperative serum gastrin（GAS） content for 1 d and 2 d was higher than that of the control group（P〈0.05）. Before operation, there was insignificant difference in SF-36 scores between the two groups（P〉0.05）. The SF-36 score in the observation group was higher than that in the control group after operation（P〈0.05）. Conclusion Laparoscopic repair of gastric perforation in treating patients with acute gastric perforation can shorten the operation time of laparoscopic gastric perforation, reduce the intraoperative blood loss, shorten the exhaust time, postoperative recovery time of bowel sound, promote the recovery of gastrointestinal function, improve the quality of life.