不同类型缝线在胃十二指肠溃疡穿孔患者微创修补术中的应用对比

Comparison of Different Types of Sutures in Minimally Invasive Repair in Patients with Gastroduodenal Ulcer Perforation

目的 研究比较不同类型缝线在胃十二指肠溃疡穿孔患者微创修补术中的应用效果。方法 选择南阳医学高等专科学校第一附属医院2019年12月至2021年11月收治的70例胃十二指肠溃疡穿孔患者,按照随机数表法分为对照组和研究组。所有患者均接受微创修补术治疗,对照组35例采用普通缝线缝合,研究组35例采用可吸收缝线缝合。比较两组相关手术指标、术后疼痛和溃疡愈合情况、肠道屏障功能(血清二胺氧化酶、D-乳酸水平)、并发症及生活质量(GIQLI评分)。结果 研究组手术、下床活动、胃肠道功能恢复及住院的所用时间均比对照组短,差异有统计学意义(P<0.05)。研究组术后1 d疼痛程度比对照组轻,且术后8周溃疡愈合率较对照组高,差异有统计学意义(P<0.05)。两组术后3 d血清二胺氧化酶、D-乳酸水平均显著升高,但研究组升高水平低于对照组,差异有统计学意义(P<0.05)。研究组并发症发生率(5.71%)较对照组(25.71%)低,差异有统计学意义(P<0.05)。两组术后8周GIQLI得分均显著升高,且研究组更高差异有统计学意义(P<0.05)。结论 与普通缝线相比,在胃十二指肠溃疡穿孔患者微创修补术中应用可吸收缝线,可有效减轻手术创伤,促进溃疡愈合,减轻疼痛程度,加快肠道屏障功能恢复,减少并发症,促进生活质量改善。

Objective To compare the application of different types of sutures in the minimally invasive repair of patients with gastroduodenal ulcer perforation. Methods Seventy patients with gastroduodenal ulcer perforation admitted to our hospital from December 2019 to November 2021 were selected and divided into a control group and a study group according to the random number table method. All patients received minimally invasive repair, 35 cases in the control group were sutured with conventional sutures, and 35 cases in the study group were sutured with absorbable sutures. Relative surgical indicators,postoperative pain, ulcer healing, intestinal barrier function(serum diamine oxidase, D-lactic acid levels), complications,and quality of life(GIQLI score) were compared between the two groups. Results The time of operation, getting out of bed,gastrointestinal function recovery, and hospitalization in the study group were shorter than that in the control group, the difference was statistically significant(P<0.05). The pain degree of the study group was less than that of the control group 1 day after surgery, and the ulcer healing rate was higher than that of the control group 8 weeks after surgery, the difference was statistically significant(P<0.05). Serum levels of diamine oxidase and D-lactic acid were significantly increased 3 days after surgery in both groups, but the increased level in the research group was lower than that in the control group, the difference was statistically significant(P<0.05). The complication rate of the study group(5.71%) was lower than that of the control group(25.71%), and the difference was statistically significant(P<0.05). GIQLI scores in both groups significantly increased 8 weeks after surgery,and the higher difference in the study group was statistically significant(P<0.05). Conclusion Compared with conventional sutures, the application of absorbable sutures in the minimally invasive repair of patients with gastroduodenal ulcer perforation can effectively reduce surgical trauma, promote ulcer healing, reduce pain, accelerate intestinal barrier function recovery, reduce complications, and promote the improvement of quality of life.