改良四孔腹腔镜穿孔修补术对胃十二指肠溃疡急性穿孔患者的影响

Effect of Modified Four-hole Laparoscopic Perforation Repair Surgery on Patients with Acute Perforation of Gastroduodenal Ulcer

目的:分析改良四孔腹腔镜穿孔修补术对胃十二指肠溃疡急性穿孔患者的影响。方法:选取2022年2月—2023年2月监利市中医医院收治的100例胃十二指肠溃疡急性穿孔患者作为研究对象。根据随机数表法将其分为观察组和对照组,各50例。对照组给予传统开腹修补术,观察组给予改良四孔腹腔镜穿孔修补术。比较两组围手术期指标,术前及术后肠道功能、疼痛程度,术后恢复情况,并发症。结果:观察组切口大小、手术时间均短于对照组,术中出血量、冲洗液使用量均少于对照组,差异有统计学意义(P<0.05)。术后,两组肠脂肪酸结合蛋白、二胺氧化酶、内毒素、D-乳酸水平均降低,观察组肠脂肪酸结合蛋白、二胺氧化酶、内毒素、D-乳酸水平均低于对照组,差异有统计学意义(P<0.05)。术后,两组视觉模拟评分法(VAS)评分均降低,观察组VAS评分低于对照组,差异有统计学意义(P<0.05)。观察组肛门排气时间、胃肠功能恢复时间、术后下床活动时间、术后住院时间均短于对照组,溃疡愈合率高于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:改良四孔腹腔镜穿孔修补术治疗胃十二指肠溃疡急性穿孔患者更具有优势,能提高术后镇痛作用,也更有利于术后肠道功能的恢复。

Objective:To analyze the effect of modified four-hole laparoscopic perforation repair surgery on patients with acute perforation of gastroduodenal ulcer.Method:A total of 100 gastroduodenal ulcer acute perforation patients admitted to Jianli Hospital of Traditional Chinese Medicine from February 2022 to February 2023 were selected as the study objects.They were divided into observation group and control group according to random number table method,with 50 cases in each group.The control group received traditional laparotomy repair surgery,and the observation group received modified four-hole laparoscopic perforation repair surgery.Perioperative indexes,preoperative and postoperative intestinal function,pain degree,postoperative recovery condition and complications were compared between the two groups.Result:The incision size and operation time in the observation group were shorter than those in the control group,and the amount of intraoperative blood loss and the amount of flushing fluid used were less than those in the control group,the differences were statistically significant(P<0.05).After surgery,the levels of intestinal fatty acid binding protein,diamine oxidase,endotoxin and D-lactic acid in both groups were decreased,and the levels of intestinal fatty acid binding protein,diamine oxidase,endotoxin and D-lactic acid in observation group were lower than those in control group,the differences were statistically significant(P<0.05).After surgery,visual analogue scale(VAS)scores of both groups were decreased,and VAS score of observation group was lower than control group,the differences were statistically significant(P<0.05).Anal exhaust time,gastrointestinal function recovery time,postoperative activity time and postoperative hospitalization time in the observation group were shorter than those in the control group,and ulcer healing rate was higher than that in the control group,the differences were statistically significant(P<0.05).The incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:The modified four-hole laparoscopic perforation repair surgery has more advantages in the treatment of gastroduodenal ulcer acute perforation patients,which can improve the postoperative analgesic effect and is more conducive to the recovery of postoperative intestinal function.