腹腔镜胃穿孔修补术患者围手术期创伤反应程度与氧化损伤状态的变化观察

Observation on the Change of Traumatic Response Degree and Oxidative Damage State of Patients with Laparoscopic Repair of Gastric Perforation during the Perioperative Period

目的:探究及观察腹腔镜胃穿孔修补术患者围手术期创伤反应程度与氧化损伤状态的变化。方法:将2018年1月-2021年12月菏泽医学专科学校附属医院和鄄城县人民医院的100例胃穿孔修补术患者按照随机数字表法分为对照组和观察组,每组50例。对照组进行开腹胃穿孔修补术治疗,观察组则进行腹腔镜胃穿孔修补术治疗。比较两组术前及术后12、24及72 h的疼痛情况[视觉模拟评分(VAS评分)]、创伤反应指标[应激激素:促肾上腺皮质激素(ACTH)及皮质醇(Cor);创伤炎症反应指标:白介素-1β(IL-1β)、白介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)]及氧化损伤相关指标[丙二醛(MDA)及脂质过氧化物(LPO)]。结果:术前两组的VAS评分、创伤反应指标及氧化损伤指标比较,差异均无统计学意义(P>0.05),术后12、24及72 h观察组的VAS评分、创伤反应指标及氧化损伤指标均先升后降,且观察组均显著优于对照组,差异均有统计学意义(P<0.05)。结论:腹腔镜胃穿孔修补术患者围手术期创伤反应程度与氧化损伤状态的波动幅度相对较小,更有助于患者术后的尽快康复。

Objective:To investigate and observe the change of traum atic response degree and oxidative damage state of patients with laparoscopic repair of gastric perforation during the perioperative period.Method:A total of 100 patients with laparoscopic repair of gastric perforation in Affiliated Hospital of Heze Medical Vocational School and Juancheng County People’s Hospital from January 2018 to December 2021 were divided into control group and observation group,with 50 cases in each group.The control group was treated with open repair of gastric perforation,the observation group was treated with laparoscopic repair of gastric perforation.Then the pain situation(VAS score),traumatic response indexes[stress hormones:adreno-cortico-tropic-hormone(ACTH)and cortisol(Cor);traumatic inflammatory response indexes:interleukin-1β(IL-1β),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)]and oxidative damage related indicators[malondialdehyde(MDA)and lipid peroxide(LPO)]of two groups before and 12,24 and 72 hours after operation were compared.Result:The VAS score,traumatic response indexes and traumatic inflammatory response indexes of two groups before operation were compared,the differences were not statistically significant(P>0.05),the VAS scores,traumatic response indexes and traumatic inflammatory response indexes of observation group at 12,24 and 72 hours after operation increased first and decreased afterward,and those of observation group were significantly better than those of control group,the differences were statistically significant(P<0.05).Conclusion:The fluctuation amplitude of traumatic response degree and oxidative damage state of patients with laparoscopic repair of gastric perforation during the perioperative period are relatively smaller,which is more conducive to the rapid recovery of patients after operation.