腹腔镜手术联合奥美拉唑三联治疗胃十二指肠溃疡穿孔的疗效观察

Curative Effect Observation on Laparoscopic Surgery Combined with Omeprazole Triple Therapy in Treatment of Gastroduodenal Ulcer Perforation

目的:探讨腹腔镜手术联合奥美拉唑三联治疗胃十二指肠溃疡穿孔的疗效。方法:回顾性分析146例胃十二指肠溃疡穿孔患者的临床资料,按随机数字表法分为常规组与观察组各73例。常规组行腹腔镜修补手术后常规对症治疗;观察组腹腔镜修补手术后联合奥美拉唑三联治疗,观察患者入院时及术后7 d的血清炎性因子(C反应蛋白、白细胞介素-6及肿瘤坏死因子-α)的水平,术后幽门螺旋杆菌(Hp)转阴所需时间、住院时间、进食时间及引流管放置时间,以及临床疗效与并发症发生率。结果:入院时两组血清炎性因子无统计学差异,术后7 d,观察组C反应蛋白、白细胞介素-6、肿瘤坏死因子-α依次为(15.12±3.86)mg/L、(8.08±1.72)ng/L、(44.96±18.35)ng/L均低于常规组(21.38±4.76)mg/L、(10.34±2.56)ng/L、(53.32±21.81)ng/L(P<0.05);术后常规组Hp转阴所需时间、住院时间、进食时间及引流管放置时间分别为(16.48±4.08)d、(10.36±2.13)d、(34.13±0.70)h、(4.82±1.05)d,均长于观察组(11.07±3.13)d、(8.02±1.08)d、(28.14±4.58)h、(3.57±0.90)d(P<0.05);观察组腹腔与切口感染发生率为2.7%(2/73),明显低于常规组的6.8%(5/73),差异有统计学意义(P<0.05);常规组与观察组分别失访2、3例,常规组术后出现粘连性肠梗阻、再穿孔等并发症的发生率11.27%(8/71),高于观察组的5.71%(4/70)(均P<0.05)。结论:腹腔镜手术奥美拉唑三联治疗胃十二指肠溃疡穿孔的临床疗效较为明显,并发症发生率降低,且安全性得到提升。

Objective To investigate the efficacy of laparoscopic surgery combined with Omeprazole triple therapy in the treatment of gastroduodenal ulcer perforation.Methods The clinical data of 146 patients with perforated gastroduodenal ulcer were retrospectively analyzed.The patients were divided into routine group and observation group by randomized digital table method was,with 73 patients in each group.The patients in the routine group underwent routine symptomatic treatment after laparoscopic repair surgery.The patients in the observation group were treated with conventional Omeprazole triple therapy after surgery.The levels of inflammatory factors(C-reactive protein,interleukin-6,and tumor necrosis factor-α)at the time of admission and 7 days after surgery were detected,and the time required for HP to become negative,hospital stay,eating time and drainage tube placement,as well as the clinical effect and complication rate were investigated.Results There were no significant differences in serum inflammatory factors between the two groups when admitted to hospital(P>0.05).The serum inflammatory factors levels in the observation group were lower than those in the routine group at 7 days after surgery(P<0.05).The time required for Hp to be negative,hospitalization time,feeding time and drainage tube placement time in the routine group were longer than those in the observation group,with statistical difference(P<0.05);The short-term efficacy of the observation group was 97.26%(71/73),which was better than that of the conventional group[93.15%(68/73)];the number of dislocations between the routine group and observation group were 2 and 3.In the conventional group,the incidence of complications such as intestinal obstruction and re-perforation was 11.27%(8/71),which was higher than that of the observation group[5.71%(4/70)](P<0.05).Conclusion For patients with clinical gastroduodenal perforation,laparoscopic surgery combined with Omeprazole triple therapy,the overall clinical effect is more obvious and and the incidence of complications decreased,meanwhile the safety can be improved.