腹腔镜下修补术治疗胃十二指肠溃疡穿孔的疗效及对VAS评分的影响

Effect of Laparoscopic Repair in the Treatment of Perforated Gastroduodenal Ulcer and its Effect on the Visual Analogue Scale

目的探究腹腔镜下修补术治疗胃十二指肠溃疡穿孔的临床疗效及对患者疼痛程度的影响。方法选取2019年2月-2022年2月佳木斯市中心医院收治的68例胃十二指肠溃疡穿孔患者,根据随机数字表法分为对照组(34例)与观察组(34例),对照组行传统开腹手术治疗,观察组行腹腔镜下修补术治疗。比较两组临床疗效、围术期指标(手术时间、术中出血量、胃肠道功能恢复时间、术后住院时间)、疼痛程度(VAS评分)、应激反应指标[C反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子α(TNF-α)]及术后并发症发生情况。结果两组治疗总有效率比较,差异无统计学意义(P>0.05);观察组手术时间、胃肠道功能恢复时间、术后住院时间均短于对照组,且术后出血量少于对照组,差异有统计学意义(P<0.05);观察组术后24 h VAS评分低于对照组,差异有统计学意义(P<0.05);两组CRP、IL-6、TNF-α水平均高于术前,差异有统计学意义(P<0.05),观察组CRP、IL-6、TNF-α水平低于对照组,差异有统计学意义(P<0.05);观察组术后并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论腹腔镜下修补术治疗胃十二指肠溃疡穿孔疗效确切,该法手术时间短、术中出血少、患者术后恢复快,疼痛程度及应激反应轻微,且手术并发症少,安全性高。

Objective To investigate the clinical efficacy of laparoscopic repair in the treatment of perforated gastroduodenal ulcer and its effect on the visual analogue scale(VAS).Methods Sixty-eight patients with perforated gastroduodenal ulcer admitted to Jiamusi Central Hospital from February 2019 to February 2022 were selected and divided into control group(34 cases)and observation group(34 cases)according to the random number table method.The control group was treated with traditional laparotomy,and the observation group was treated with laparoscopic repair.The clinical efficacy,perioperative indicators(operation time,intraoperative blood loss,gastrointestinal function recovery time,postoperative hospital stay),pain degree(VAS score),stress response indicators[C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factorα(TNF-α)]and postoperative complications were compared between the two groups.Results There was no significant difference in the total effective rate between the two groups(P>0.05).The operation time,gastrointestinal function recovery time and postoperative hospital stay in the observation group were shorter than those in the control group,and the postoperative bleeding volume was less than that in the control group,the differences were statistically significant(P<0.05).The VAS score of the observation group was lower than that of the control group at 24 h after operation,and the difference was statistically significant(P<0.05).The levels of CRP,IL-6 and TNF-αin the two groups were higher than those before operation(P<0.05);while the levels of CRP,IL-6 and TNF-αin the observation group were lower than those in the control group(P<0.05).The incidence of postoperative complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Laparoscopic repair is effective in the treatment of perforated gastroduodenal ulcer.This method has short operation time,less intraoperative bleeding,rapid postoperative recovery,mild pain and stress response,fewer complications and high safety.