腹腔镜微创修补术治疗急诊胃十二指肠溃疡穿孔的临床疗效观察

Clinical observation of laparoscopic minimally invasive repair for emergency gastroduodenal ulcer perforation

目的 分析腹腔镜微创修补术应用在急诊胃十二指肠溃疡穿孔患者中的临床疗效。方法 选择80例急诊胃十二指肠溃疡穿孔患者,依据随机数表法分为对照组和研究组,每组40例。对照组以开放式修补术实施治疗,研究组以腹腔镜微创修补术进行治疗。对比两组手术相关指标、胃肠激素指标、并发症发生情况及胃肠动力情况。结果 研究组患者手术用时(61.94±8.21)min、住院时间(3.23±0.57)d、下床活动时间(1.34±0.26)d均短于对照组的(84.36±12.67)min、(5.98±1.65)d、(2.37±0.39)d,手术切口长度(2.12±0.34)cm、失血量(41.14±3.63)ml均小于对照组的(5.14±1.13)cm、(144.82±16.43)ml,差异具有统计学意义(P<0.05);研究组胃肠减压解除时间、肛门首次排气时间、肠鸣音恢复时间分别为(24.32±5.67)、(29.52±4.36)、(12.72±2.87)h,均比对照组的(33.83±7.42)、(38.51±5.75)、(18.54±3.93)h短,差异具有统计学意义(P<0.05);研究组胃泌素(GAS)(101.93±10.41)ng/L、胃动素(MOT)(252.37±25.87)ng/L、生长抑素(SS)(23.89±6.78)ng/L比对照组的(90.76±9.67)、(226.94±26.38)、(18.26±6.32)ng/L高,差异具有统计学意义(P<0.05);治疗后,研究组并发症发生率为7.50%,低于对照组的25.00%,差异具有统计学意义(P<0.05)。结论 腹腔镜微创修补术应用在急诊胃十二指肠溃疡穿孔患者治疗中的临床疗效较好,可促使患者的胃肠激素、胃肠动力情况得到改善,降低术后并发症,帮助患者在最短时间内康复,临床上值得推广使用。

Objective To analyze the clinical efficacy of laparoscopic minimally invasive repair for emergency gastroduodenal ulcer perforation.Methods 80 patients with emergency gastroduodenal ulcer perforation were divided into a control group and a study group according to random number table,with 40 cases in each group.The control group was treated with open repair,and the study group was treated with laparoscopic minimally invasive repair.The surgical related indicators,gastrointestinal hormones,complications and gastrointestinal motility were compared between the two groups.Results The study group had operation time of(61.94±8.21)min,hospitalization time of(3.23±0.57)d and ambulation time of(1.34±0.26)d,which were shorter than(84.36±12.67)min,(5.98±1.65)d and(2.37±0.39)d in the control group;the study group had incision length of(2.12±0.34)cm and blood loss of(41.14±3.63)ml,which were less than(5.14±1.13)cm and(144.82±16.43)ml in the control group;the difference was statistically significant(P<0.05).In the study group,the duration of gastrointestinal decompression,the first anal exhaust time and the recovery time of intestinal sound were(24.32±5.67),(29.52±4.36)and(12.72±2.87)h,which were shorter than(33.83±7.42),(38.51±5.75)and(18.54±3.93)h in the control group.The difference was statistically significant(P<0.05).The study group had gastrin(GAS)of(101.93±10.41)ng/L,motilin(MOT)of(252.37±25.87)ng/L,somatostatin(SS)of(23.89±6.78)ng/L,which were higher than(90.76±9.67),(226.94±26.38)and(18.26±6.32)ng/L in the control group,and the difference was statistically significant(P<0.05).After treatment,the complication rate of the study group was 7.50%,which was lower than 25.00%of the control group,and the difference was statistically significant(P<0.05).Conclusion Laparoscopic minimally invasive repair has good clinical efficacy in patients with emergency gastroduodenal ulcer perforation,which can improve the gastrointestinal hormones and gastrointestinal motility of patients,reduce postoperative complications,and help patients recover in the shortest possible time,which is worth promoting in clinical practice.