[1]王建华,陈 翔.腹腔镜修补术对胃穿孔患者术后疼痛及康复指标的影响[J].国外医学医学地理杂志,2019,(02):171-173,183.[doi:10.3969/j.issn.1001-8883.2019.02.021]
 WANG Jianhua,CHEN Xiang.Effects of laparoscopic repair on postoperative pain and rehabilitationindexes in patients with gastric perforation[J].Foreign Medical Sciences (Section of Medgeography),2019,(02):171-173,183.[doi:10.3969/j.issn.1001-8883.2019.02.021]
点击复制

腹腔镜修补术对胃穿孔患者术后疼痛及康复指标的影响()
分享到:

国外医学医学地理杂志[ISSN:1001-8883/CN:61-1102/R]

卷:
期数:
2019年02期
页码:
171-173,183
栏目:
临床医学
出版日期:
2019-07-02

文章信息/Info

Title:
Effects of laparoscopic repair on postoperative pain and rehabilitationindexes in patients with gastric perforation
作者:
王建华1陈 翔2
(甘肃省人民医院:1.普外科; 2.消化科,甘肃兰州 730000)
Author(s):
WANG Jianhua1CHEN Xiang2
(1.General Surgery; 2.Department of Gastroenterology,Gansu Provincial People’s Hospital,Lanzhou 730000,China)
关键词:
胃穿孔 腹腔镜修补术 血清胃泌素 胃肠动力 并发症
Keywords:
gastric perforation laparoscopic repair serum gastrin gastrointestinal motility complications
分类号:
R722
DOI:
10.3969/j.issn.1001-8883.2019.02.021
文献标志码:
A
摘要:
目的 探讨腹腔镜修补术对胃穿孔患者术后疼痛及康复指标的影响。方法 选取本院2016年1月至2019年1月就诊的96例胃穿孔患者,根据患者自身意愿将其分为研究组和对照组,每组48例,对照组及研究组分别行传统的开腹胃穿孔修补术及腹腔镜胃穿孔修补术,比较两组的手术情况、术后疼痛程度及胃肠动力恢复情况及并发症发生率。结果 研究组的切口长度、手术时间、术中出血量、下床活动时间及住院时间均显著少于对照组(P<0.01),研究组术后12、48、72 h及7 d的VAS评分均显著低于对照组(P<0.05),术后1 h两组的血清胃泌素水平无统计学差异(P>0.05),术后24、48及72 h研究组的血清胃泌素水平显著高于对照组,且研究组术后排气时间及肠鸣音恢复时间显著短于对照组(P<0.05),研究组术后并发症发生率显著低于对照组(P<0.05)。结论 腹腔镜修补术创伤性小,术后疼痛轻微,并发症少,可有效改善患者的胃肠动力,对促进术后恢复具有积极意义。
Abstract:
Objective To explore the effect of laparoscopic repair on postoperative pain and rehabilitation indexes in patients with gastric perforation.Methods The total of 96 patients with gastric perforation who were admitted to our hospital from Jan.2016 to Jan.2019.According to the patient’s own wishes,they were divided into the study group and the control group,and 48 cases of each group.The patients in the control group and the study group underwent conventional open gastric perforation repair and laparoscopic gastric perforation repair.Surgery,postoperative pain and gastrointestinal motility recovery and complication rate were compared of the two groups.Results The length of incision,the operation time,the intraoperative blood loss,the time of getting out of bed,and the hospital stay were significantly lower in the study group than in the control group(P<0.01).The VAS scores of the study group at 12 h,48 h,72 h and 7 d were significantly lower than those of the control group(P<0.05).There was no significant difference in serum gastrin levels between the two groups at 1 h postoperative(P>0.05).The serum gastrin level in the study group was significantly higher than those in the control group at 24 h,48 h,and 72 h after surgery,and the postoperative exhaust time and bowel sound recovery time in the study group were significantly shorter than those in the control group(P<0.05).The postoperative complication rate of the study group was significantly lower than that of the control group(P<0.05).Conclusion Laparoscopic repair is less invasive,with less postoperative pain and less complications.It can effectively improve the gastrointestinal motility of patients and has positive significance for promoting postoperative recovery.

参考文献/References:


[1] 何劲松,李利发,张井潇,等.国内腹腔镜与开腹修补术在良性胃穿孔患者中应用的Meta分析[J].川北医学院学报,2016,31(4):493-499.
[2] 黄树民.腹腔镜修补术与开腹修补术治疗胃穿孔术后胃肠动力恢复情况对比研究[J].临床和实验医学杂志,2016,15(24):2467-2469.
[3] 靳和平.腹腔镜胃穿孔修补术治疗胃穿孔对炎症因子的影响[J].腹腔镜外科杂志,2017,22(10):734-737.
[4] 赵煜.腹腔镜胃穿孔修补术患者围术期细胞因子及疼痛相关血清指标分析[J].浙江临床医学,2015,17(11):1859-1860.
[5] 黄进,刘晓翔.胃穿孔微创术式与传统开放性修补术对患者胃肠动力的影响研究[J].河北医学,2016,22(1):40-43.
[6] 林莉,朱一宁,朱智军,等.腹腔镜微创手术对胃穿孔患者的疗效及胃肠动力的影响[J].现代生物医学进展,2017,17(9):142-144.
[7] 王群先,纪珍花.腹腔镜胃穿孔修补术患者胃肠功能状态及炎性应激状态变化观察[J].实用临床医药杂志,2017,21(24):149-150.
[8] 吴世乐,郭亚民,吴新民.胃穿孔腹腔镜修补术的手术方法及临床效果观察[J].中国现代普通外科进展,2017,20(4):306-308.
[9] 侯花屏,冯江,刘新奇,等.腹腔镜下穿孔修补术治疗老年胃溃疡合并胃穿孔的临床观察[J].老年医学与保健,2017,23(6):502-504.
[10] 刘友春,邵焓.腹腔镜下修补术对老年胃穿孔的疗效[J].贵阳医学院学报,2018,43(3):349-352.
[11] 李克峰,王静,雷娟.腹腔镜下穿孔修补术与胃大部分切除术对真菌感染胃溃疡合并胃穿孔的疗效对比[J].山西医药杂志,2019,48(5):548-550.
[12] 陈宇开.腹腔镜胃穿孔修补术对患者胃电参数及血清消化功能相关指标的影响[J].海南医学院学报,2014,20(9):1225-1227.
[13] 章永峰,胡晓明,王志刚,等.腹腔镜与开腹手术治疗胃穿孔效果对比观察[J].人民军医,2015,58(4):380-381.
[14] 杨河,胡军,陈立智,等.腹腔镜修补术治疗胃穿孔的疗效及安全性[J].海南医学,2017,28(23):3915-3917.
[15] 吕述明.胃穿孔患者68例应用腹腔镜与开腹手术治疗的效果对比分析[J].中国医疗器械信息,2018,24(6):92-93.
[16] 姜正科,俞晓军,朱顺福,等.腹腔镜胃穿孔修补术患者围术期血清白介素、应激激素及氧化应激的变化研究[J].中国内镜杂志,2014,20(5):514-517.

备注/Memo

备注/Memo:
收稿日期:2018-11-29 修回日期:2019-01-22
作者简介:王建华(1968-),男(汉族),大学本科,主治医师.研究方向:腹腔镜手术.
更新日期/Last Update: 2019-07-02