摘要
目的探讨腹腔镜穿孔修补术联合四联疗法治疗急性胃溃疡穿孔患者的疗效。方法选取2020-01-14-2022-01-14郑州大学附属郑州中心医院收治的90例急性胃溃疡穿孔患者作为研究对象,随机分为手术组及联合组,各45例。其中手术组患者给予腹腔镜穿孔修补术治疗,联合组患者给予腹腔镜穿孔修补术联合四联疗法治疗。比较2组血清炎性因子水平[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]、胃电参数(主频、主功率、正常慢波节律比)、血清胃动素和胃泌素水平、术后疼痛程度[视觉模拟评分法(VAS)]及并发症发生情况。结果联合组及手术组治疗后血清hs-CRP水平分别为(2.54±0.55)和(3.11±0.68)mg/L,TNF-α水平分别为(1.65±0.41)和(3.84±1.19)μg/L,IL-6水平分别为(11.78±1.23)和(16.24±1.73)pg/mL,胃泌素水平分别为(89.38±9.64)和(106.79±11.13)pg/mL,均较治疗前明显降低;而主频分别为(3.29±0.68)和(3.01±0.61)次/min,主功率分别为(37.25±3.81)和(33.46±3.38)dB,正常慢波节律比分别为(74.83±7.55)%和(71.48±7.23)%,血清胃动素分别为(231.48±23.88)和(203.74±20.08)mg/L,均较治疗前明显升高,均P<0.05。协方差主体间效应检验结果显示,2组干预后上述指标比较差异均有统计学意义均P<0.05;重复测量方差结果显示,2组疼痛程度不同时间点比较差异有统计学意义,F时间=54.781,P<0.001。联合组治疗过程中术后切口感染、腹腔脓肿、穿孔复发等并发症发生率为4.44%,低于手术组的22.22%,χ^(2)=4.712,P=0.030。结论腹腔镜穿孔修补术联合四联疗法治疗急性胃溃疡穿孔患者可有效改善胃肠功能、减轻疼痛、调节炎性反应、安全有效。
Objective To explore the efficacy of laparoscopic perforation repair combined with quadruple therapy in the treatment of patients with acute gastric ulcer perforation.Methods Ninety patients with acute gastric ulcer perforation who were admitted by Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 14,2020 to January 14,2022 were selected as research objects and randomly grouped into the operation group(45 cases)and the combination group(45 cases).The patients in the operation group were treated with laparoscopic perforation repair,and the patients in the combination group were treated with laparoscopic perforation repair combined with quadruple therapy.We compared the levels of serum inflammatory factors[high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)],gastric electrical parameters(main frequency,main power,normal slow-wave rhythm ratio),serum motilin and gastrin levels,postoperative pain level[visual analog scale(VAS)]and complications.Results The serum hs-CRP levels in the combined group and the operation group after treatment were(2.54±0.55)and(3.11±0.68)mg/L,respectively;TNF-αlevels were(1.65±0.41)and(3.84±1.19)μg/L,respectively;IL-6 levels were(11.78±1.23)and(16.24±1.73)pg/ml;gastrin levels were(89.38±9.64)and(106.79±11.13)pg/ml,respectively,which were significantly lower than those before treatment.The main frequency in the combined group and the operation group were(3.29±0.68)and(3.01±0.61)times/min,respectively,main power were(37.25±3.81)and(33.46±3.38)dB,respectively,normal slow wave rhythm ratio were(74.83±7.55)%and(71.48±7.23)%,respectively,serum motilin were(231.48±23.88)and(203.74±20.08)mg/L,respectively,which were significantly higher than those before treatment(all P<0.05).The covariance between-subject effect test showed that the above indicators were significantly different between the two groups after intervention(P<0.05);Repeated measurement variance showed that there was a statistically significant difference in pain level at different time points(Ftime=54.781,P<0.001).The incidence of postoperative incision infection,abdominal abscess,recurrence of perforation and other complications in the combined group was 4.44%,which was remarkably lower than that in the operation group of 22.22%,χ^(2)=4.712,P=0.030.Conclusion Laparoscopic perforation repair combined with quadruple therapy in treating acute gastric ulcer perforation can effectively ameliorate gastrointestinal function,relieve pain,and regulate inflammatory response with safety and effectiveness.
作者
刘栋
杜雪
LIU Dong;DU Xue(Department of Gastrointestinal Hernia and Abdominal Wall,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 45001,China;Department of Imaging,Zhengzhou Children's Hospital,Zhengzhou 450012,China)
出处
《社区医学杂志》
CAS
2022年第23期1327-1331,共5页
Journal Of Community Medicine
关键词
急性胃溃疡穿孔
四联疗法
腹腔镜穿孔修补术
胃肠功能
acute gastric ulcer perforation
quadruple therapy
laparoscopic perforation repair
gastrointestinal function
