经脐单孔腹腔镜胃十二指肠溃疡穿孔修补术治疗胃十二指肠溃疡穿孔患者的效果

Effect of Transumbilical Single-Port Laparoscopic Perforation Repair in Patients with Gastroduodenal Ulcer Perforation

目的探讨经脐单孔腹腔镜胃十二指肠溃疡穿孔修补术治疗胃十二指肠穿孔患者的效果。方法回顾性分析2019年7月至2022年7月驻马店市中心医院收治的62例胃十二指肠穿孔患者,根据治疗方案将上述研究对象分为传统手术组(44例)以及单孔腹腔镜组(18例)。传统手术组患者接受常规多孔腹腔镜穿孔修补术;单孔腹腔镜组接受经脐单孔腹腔镜穿孔修补术。记录两组术中出血量、术后肠鸣音恢复时间、总住院时间、术后24 h的疼痛视觉模拟评分(VAS)、术后镇痛剂使用率、切口美观度评分、手术前后降钙素原(PCT)、白介素-6(IL-6)以及超敏C反应蛋白(hs-CRP)水平、术后并发症发生率、术后3个月溃疡穿孔复发率。结果单孔腹腔镜组的手术时间长于传统手术组,术中出血量、术后肠鸣音恢复时间、总住院时间、术后24 h VAS评分、术后镇痛剂使用率低于传统手术组,切口美观度评分高于传统手术组,差异有统计学意义(P<0.05);术后,两组PCT、IL-6以及hs-CRP水平相比术前均下降,且单孔腹腔镜组低于传统手术组(P<0.05);单孔腹腔镜组的并发症发生率低于传统手术组,差异有统计学意义(P<0.05);术后3个月两组均未出现复发病例(P>0.05)。结论经脐单孔腹腔镜治疗胃十二指肠溃疡穿孔效果良好,相比多孔腹腔镜术,可缩短康复时间、缓解疼痛与炎症反应,并降低并发症发生率,安全性较高。

Objective To explore the effect and safety of transumbilical single-port laparoscopic perforation repair in patients with gastroduodenal ulcer perforation.Methods A total of 62 patients with gastroduodenal perforation admitted to Zhumadian Central Hospital were retrospectively analyzed from July 2019 to July 2022.According to treatment methods,they were divided into traditional surgery group(routine porous laparoscopic perforation repair,44 cases)and single-port laparoscopy group(transumbilical single-port laparoscopic perforation repair,18 cases).The intraoperative blood loss,postoperative recovery time of bowel sound,total hospitalization time,score of visual analogue scale(VAS)at 24 h after surgery,postoperative use rate of analgesics,score off incision aesthetics,levels of procalcitonin(PCT),interleukin-6(IL-6)and hypersensitive C-reactive protein(hs-CRP)before and after surgery,incidence of postoperative complications and recurrence rate of ulcer perforation at 3 months after surgery in the two groups were recorded and compared.Results The operation time in single-port laparoscopy group was longer than that in traditional surgery group,intraoperative blood loss,postoperative recovery time of bowel sound,total hospitalization time,VAS score at 24 h after surgery and postoperative use rate of analgesics were lower than those in traditional surgery group,and score of incision aesthetics was significantly higher than that in traditional surgery group(P<0.05).After surgery,levels of PCT,IL-6 and hs-CRP in both groups were decreased,which were lower in single-port laparoscopy group than those in traditional surgery group(P<0.05).The incidence of postoperative complications in single-port laparoscopy group was lower than that in traditional surgery group(P<0.05).At 3 months after surgery,there was no recurrence of ulcer perforation in either group(P>0.05).Conclusion Transumbilical single-port laparoscopy has good curative effect in gastroduodenal ulcer perforation.Compared with traditional porous laparoscopy,it can shorten recovery time,relieve pain and inflammatory response,and reduce the incidence of complications,with high safety.