腹腔镜下修补术治疗胃十二指肠溃疡穿孔的疗效及对患者疼痛的影响

Efficacy of Laparoscopic Repair in the Treatment of Gastroduodenal Ulcer Perforation and its Effect on Patients'Pain

目的探讨腹腔镜下修补术治疗胃十二指肠溃疡穿孔的疗效及对患者疼痛的影响。方法选取2021年5月-2022年5月在我院诊治的66例胃十二指肠溃疡穿孔患者为研究对象,采用随机数字表法分为对照组和观察组,各组33例。对照组采用常规开腹术治疗,观察组采用腹腔镜下修补术治疗,比较两组临床疗效、手术指标、疼痛(VAS)评分、胃功能指标[胃动素(MTL)、胃泌素(GAS)]及并发症发生率。结果观察组总有效率为93.94%,高于对照组的81.82%(P<0.05);观察组手术时间、术中出血量、胃肠功能恢复时间、下床活动时间均小于对照组(P<0.05);术后2 h两组疼痛评分比较,差异无统计学意义(P>0.05),术后8、24 h观察组疼痛评分均低于对照组(P<0.05);两组MTL、GAS水平均高于术前,且观察组高于对照组(P<0.05);观察组并发症发生率为6.06%,低于对照组的18.18%(P<0.05)。结论腹腔镜下修补术治疗胃十二指肠溃疡穿孔效果确切,可减轻患者疼痛评分,改善手术指标,促进胃功能恢复,且可降低并发症发生率,是一种安全、有效的治疗方案。

Objective To investigate the effect of laparoscopic repair on gastroduodenal ulcer perforation and its effect on patients'pain.Methods A total of 66 patients with gastroduodenal ulcer perforation diagnosed and treated in our hospital from May 2021 to May 2022 were selected as the research objects.They were divided into control group and observation group by random number table method,with 33 cases in each group.The control group was treated with conventional laparotomy,and the observation group was treated with laparoscopic repair.The clinical efficacy,surgical indicators,pain(VAS)score,gastric function indicators[motilin(MTL),gastrin(GAS)]and complication rate were compared between the two groups.Results The total effective rate of the observation group was 93.94%,which was higher than 81.82%of the control group(P<0.05).The operation time,intraoperative blood loss,gastrointestinal function recovery time and ambulation time in the observation group were less than those in the control group(P<0.05).There was no significant difference in pain scores between the two groups at 2 h after operation(P>0.05).The pain scores of the observation group were lower than those of the control group at 8 and 24 h after operation(P<0.05).The levels of MTL and GAS in the two groups were higher than those before operation,and those in the observation group were higher than those in the control group(P<0.05).The incidence of complications in the observation group was 6.06%,which was lower than 18.18%in the control group(P<0.05).Conclusion Laparoscopic repair is effective in the treatment of gastroduodenal ulcer perforation,which can reduce the pain score,improve the surgical index,promote the recovery of gastric function,and reduce the incidence of complications.It is a safe and effective treatment.