腹腔镜胃穿孔修补术治疗胃穿孔的效果及对IL-6、TNF-α、CRP水平的影响

Effects of laparoscopic gastric perforation repair on gastric perforation and its influence on the levels of IL-6,TNF-αand CRP

目的 研究腹腔镜胃穿孔修补术治疗胃穿孔的效果及对IL-6、TNF-α、CRP水平的影响.方法 选取112例我院2018年5月~2019年6月收治的胃溃疡并发胃穿孔患者,按照手术方法的不同分为对照组和实验组,各56例.对照组使用开腹修补术治疗,实验组使用腹腔镜胃穿孔修补术.比较两组手术相关指标,手术前后IL-6、TNF-α、CRP水平的变化及术后并发症发生情况.结果 与对照组比较,实验组的手术时间、住院时间、切口长度均明显缩短,术中出血量明显减少且并发症发生率较低,差异有统计学意义(P<0.05);与术前比较,术后24~72h两组IL-6、TNF-α、CRP水平均先升高后降低,且术后24、72h实验组升高与降低的幅度均低于对照组,差异有统计学意义(P<0.05).结论 腹腔镜胃穿孔修补术用于治疗胃穿孔时的手术时间、住院时间、切口长度较短,术中出血量较少且并发症发生率较低,同时可显著降低患者术后的炎症反应.

Objective To study the effect of laparoscopic gastric perforation repair on gastric perforation and its influence on the levels of interleukin-6(IL-6),tumor necrosis factor(TNF-α)and C-reactive protein(CRP).Methods A total of 112 patients with gastric ulcer complicated by gastric perforation who were treated in our hospital from May 2018 to June 2019 were selected and divided into a control group and a study group according to different surgical methods,with 56 cases in each group.The control group was treated with laparotomy and the study group was treated with laparoscopic gastric perforation.The operation-related indicators,changes in IL-6,TNF-α,and CRP levels and postoperative complications were compared between the two groups.Results Compared with the control group,the operation time,length of hospital stay,and incision length of the study group were significantly shorter,the amount of bleeding during the operation was significantly less,and the incidence of complications was lower.Compared with before treatment,the levels of IL-6,TNF-αand CRP at 24-72h after treatment increased first and then decreased,and the degree of the increase and decrease in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Laparoscopic gastric perforation repair for gastric perforation features shorter operation time,hospitalization stay and incision length,less intraoperative blood loss and lower incidence of complications,and can significantly reduce the postoperative inflammatory response in patients.