胃大部分切除术与单纯修补术治疗急性胃穿孔的效果比较

Comparison on curative effect of subtotal gastrectomy and simple repair on acute gastric perforation

目的对比分析胃大部分切除术与单纯修补术治疗急性胃穿孔的临床效果。方法随机对照研究。抽取2020年3月至2023年3月信阳市中心医院急诊科收治的120例急性胃穿孔患者作为研究对象,根据电脑随机数表法分为对照组与观察组,每组60例。对照组予以胃大部分切除术,观察组予以单纯修补术,比较两组患者的围术期指标、应激反应及安全性。结果观察组术中失血量少于对照组,手术操作时间、肛门排气、肠鸣音恢复、术后首次下床及住院时间均短于对照组(P均<0.05);观察组白细胞介素-6、C反应蛋白与降钙素原水平均低于对照组(P均<0.05);观察组并发症发生率(5.00%,3/60)低于对照组(16.67%,10/60),P<0.05。结论急性胃穿孔临床治疗中,与胃大部分切除术相比,单纯修补术在改善围术期指标、降低应激反应及提高安全性方面更具优势。

Objective To compare the effect of subtotal gastrectomy and simple repair in the treatment of acute gastric perforation.Methods This study was a randomized controlled trail.A total of 120 patients with acute gastric perforation who were admitted to the Emergency Department of Xinyang Central Hospital from March 2020 to March 2023 were selected,and they were divided into control group and observation group according to the computer random number table method,with 60 cases in each group.The control group was treated by subtotal gastrectomy,and the observation group was treated by simple repair.The perioperative indexes,stress response and safety of the two groups were compared.Results The intraoperative blood loss in the observation group was less,while the operation time,anal exhaust time,bowel sound recovery time,the first ambulation time after surgery and length of hospital stay in the observation group were shorter,compared with the control group(all P<0.05).The levels of interleukin-6,C-reactive protein and procalcitonin in the observation group were all lower than those in the control group(all P<0.05).The incidence of complications in the observation group(5.00%,3/60)was lower than that in the control group(16.67%,10/60),P<0.05.Conclusions In the clinical treatment of acute gastric perforation,simple repair has more advantages in improving perioperative indexes,reducing stress response and improving safety,compared with subtotal gastrectomy.