胃穿孔腹腔镜修补术后患者胃肠动力恢复效果探讨

Effect of gastrointestinal motility recovery after laparoscopic repair of gastric perforation

目的:讨论胃穿孔腹腔镜修补术对患者胃肠动力恢复的影响。方法:选取2019年1月至2021年12月本院胃穿孔患者40例,随机分成对照组与观察组,各20例。对照组行传统手术治疗,观察组行腹腔镜修复术治疗,比较两组的胃肠动力恢复情况、手术情况、生活质量、血清胃泌素、应激反应、并发症。结果:观察组术后首次排气、肠鸣音恢复、下床活动等恢复时间均短于对照组(P<0.05);观察组手术时间短于对照组,术中出血量少于对照组(P<0.05);观察组各项生活质量分数高于对照组(P<0.05);观察组术后1.h、1.d、3.d的血清胃泌素均高于对照组(P<0.05);观察组的肾上腺素、皮质醇低于对照组(P<0.05);观察组术后并发症低于对照组(P<0.05)。结论:胃穿孔腹腔镜修补术下的疗效更为可观,患者术后的胃肠动力恢复时间更短,且手术时间短,安全性高,血清胃泌素受损小,术中应激反应低,术后并发症少,更利于患者生活质量的提高。

Objective:To discuss the effect of laparoscopic repair of gastric perforation on the recovery of gastrointestinal motility.Methods:40 patients with gastric perforation in our hospital from January 2019 to January 2022 were randomly divided into two groups:control group and observation group(20 cases in each group).The control group was treated with traditional surgery and the observation group was treated with laparoscopic repair.The recovery of gastrointestinal motility,operation,quality of life,serum gastrin,stress response and complications were compared between the two groups.Results:The recovery time of the first postoperative exhaust,bowel sound recovery and out of bed activity in the observation group were shorter than those in the control group(P<0.05).The operation time in the observation group was shorter than that in the control group,and the amount of intraoperative bleeding was less than that in the control group(P<0.05).The scores of quality of life in the observation group were higher than those in the control group(P<0.05).The levels of serum gastrin in the observation group at 1 h,1 d and 3 d after operation were higher than those in the control group(P<0.05).Adrenaline and cortisol in the observation group were lower than those in the control group(P<0.05).The postoperative complications in the observation group were lower than those in the control group(P<0.05).Conclusion:Laparoscopic repair of gastric perforation is more effective,the recovery time of gastrointestinal motility is shorter,the operation time is short,the safety is high,the damage of serum gastrin is small,the intraoperative stress response is low,and there are few complications after operation,which is more conducive to the improvement of patients’quality of life.