艾司奥美拉唑在腹腔镜胃溃疡穿孔倒刺线缝合修补术后辅助治疗中的应用价值

The application value of esomeprazole in the adjuvant treatment of laparoscopic gastric ulcer perforation with barbed suture repair

目的探讨艾司奥美拉唑在腹腔镜胃溃疡穿孔倒刺线缝合修补术后辅助治疗中的应用价值。方法选取2021年9月至2023年9月抚州市第一人民医院急诊外科收治的68例胃溃疡穿孔患者作为研究对象,随机分为对照组与观察组,各34例。两组均实施腹腔镜胃溃疡穿孔修补术治疗,对照组术后予以其他药物治疗,观察组术后则联合艾司奥美拉唑治疗。比较两组临床疗效、血清转化生长因子α(TGF-α)水平、胃泌素(Gas)水平、血清炎症因子指标[C-反应蛋白(CRP)、白细胞介素-6(IL-6)]、免疫功能指标(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))。结果观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05);治疗后,两组TGF-α水平均高于治疗前,Gas水平均低于治疗前,且观察组TGF-α水平高于对照组,Gas水平低于对照组,差异有统计学意义(P<0.05);治疗后,两组CRP、IL-6水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组CD4^(+)水平及CD4^(+)/CD8^(+)均高于治疗前,CD8^(+)水平低于治疗前,且观察组CD4^(+)水平及CD4^(+)/CD8^(+)均高于对照组,CD8^(+)水平低于对照组,差异有统计学意义(P<0.05)。结论艾司奥美拉唑在腹腔镜胃溃疡穿孔倒刺线缝合修补术后辅助治疗的应用价值较高,不仅可改善患者黏膜环境,促进溃疡恢复,还能避免机体炎症反应加剧,调节机体免疫功能,进一步巩固手术疗效,促进病情康复。

Objective To investigate the application value of esomeprazole in the adjuvant treatment of laparoscopic gastric ulcer perforation with barbed suture repair.Methods A total of 68 patients with gastric ulcer perforation admitted to the Department of Emergency Surgery of the Fu-zhou First People's Hospital from September 2021 to September 2023 were selected as the research subjects,and they were randomly divided into the control group and the observation group,with 34 cases in each group.Both groups were treated with laparoscopic gastric ulcer perforation repair,the control group was treated with other drugs after operation,while the observation group was treated with esomeprazole after operation.The clini-cal efficacy,serum transforming growth factor-α(TGF-α)level,gastrin(Gas)level,serum inflammatory factor indexes(C-reactive protein[CRP],in-terleukin-6[IL-6])and immune function indexes(CD4^(+),CD8^(+),CD4^(+)/CD8^(+))were compared between the two groups.Results The total effective rate in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).After treatment,the lev-els of TGF-αof the two groups were higher than those before treatment,the levels of Gas were lower than those before treatment,and the level of TGF-αin the observation group was higher than that in the control group,the level of Gas was lower than that in the control group,the differences were statistically significant(P<0.05).After treatment,the levels of CRP and IL-6 of the two groups were lower than those before treatment,and the observation group was lower than the control group,the differences were statistically significant(P<0.05).After treatment,the levels of CD4^(+)and CD4^(+)/CD8^(+)of the two groups were higher than those before treatment,the levels of CD8^(+)were lower than those before treatment,and the levels of CD4^(+)and CD4^(+)/CD8^(+)in the observation group were higher than those in the control group,the level of CD8^(+)was lower than that in the control group,the differences were statistically significant(P<0.05).Conclusion Esomeprazole has high application value in the adjuvant treatment of lap-aroscopic gastric ulcer perforation with barbed suture repair,it can not only improve the mucosal environment of patients,but also promote the recov-ery of ulcer,at the same time,it can avoid the aggravation of inflammatory reaction,regulate the immune function of the body,further consolidate the curative effect of surgery,and promote the recovery of the disease.