腹腔镜胃十二指肠溃疡穿孔修补术降低患者应激反应临床分析

目的探讨腹腔镜下胃十二指肠溃疡穿孔修补术降低患者应激反应的临床效果。方法回顾性分析2014年1月至2015年5月间150例不同手术方法治疗胃十二指肠溃疡穿孔修补术患者(腹腔镜组84例,开腹组66例)的临床资料,应用SPSS18.0软件包进行数据分析,手术时间、术中出血量、术后回房时疼痛水平(VAS评分)、排气时间、住院天数、抗生素使用时间、术后1 d的白细胞数目、粒细胞百分比、CRP、IL-6、TNF-α和血糖水平等计量资料以(x珋±s)表示,采用t检验;并发症发生率等计数资料采用χ2检验。P0.05为差异具有统计学意义。结果腹腔镜组患者手术时间和术中出血量显著低于开腹组(t=1.954、1.880,P0.05);腹腔镜组患者术后疼痛评分、排气时间、住院天数和抗生素使用时间明显优于开腹组(t=11.448、5.857、6.582、5.623,P0.01);腹腔镜组患者术后1 d的白细胞数目、粒细胞百分比、CRP、IL-6、TNF-α和血糖水平显著低于开腹组(t=7.236、5.340、20.553、21.585、24.697、2.851,P0.01)差异均有统计学意义。两组患者并发症发生率差异无统计学意义(χ2=2.240,P0.05)。结论腹腔镜下胃十二指肠溃疡穿孔修补术患者术中损伤小、应激反应低术后恢复快,具有临床应用价值。

Stress response of patients with gastroduodenal ulcer after laparoscopic neoplasty of perforation

Objective To investigate patients ’ stress response after laparoscopic repair of gastroduodenal ulcer perforation . Methods The clinical data of 150 patients treated from January 2014 to May 2015 were analyzed retrospectively .In these patients, 84 patients who underwent laparoscopic repair of gastroduodenal ulcer served as an observation group and 66 patients received open surgical repair of gastroduodenal ulcer as an open group .SPSS18.0 software was used for statistical analysis .Measurement data represented as mean ±SD were examined by Student’s t test.They included operation time, blood loss, postoperative pain (VAS scoring), exhaust time, days of hospitalization, time of antibiotic usage, number of white blood cells, percentage of granulocytes , CRP, IL-6, TNF-α, and glucose levels one day after surgery . Postoperative complication rate was examined by the Chi-square test.P<0.05 was considered statistically significant . Results The operation time and blood loss in the observation group were significantly less than those in the open group (t =1.954, t =1.880 respectively, P <0.05).Pain scoring, anorectum exhaust time, length of hospital stay and time of antibiotic use in the observation group were significantly less than those in the open group (t=11.448, 5.857, 6.582, 5.623 respectively, P<0.01).The white blood cell count, neutrophil percentage, blood glucose and C-reactive protein, IL-6, TNF-αin the observation group were significantly less than those in the open group ( t=7.236, 5.340, 20.553, 21.585, 24.697, 2.851 respectively, P <0.01).There was no significant difference in complication rate between the two groups (χ2 =2.240, P>0.05). Conclusion Laparoscopic repair of gastroduodenal ulcer perforation could result in less intraoperative injury , reduce stress response , and improve the recovery of patients .