中国医学创新2016，Vol.13Issue(32)：28-31,4.DOI:10.3969/j.issn.1674-4985.2016.32.008
腹腔镜与开腹修补术治疗老年上消化道穿孔的对照研究
Control Study of Laparoscopic and Open Repair in the Treatment of Elderly Patients with Upper Digestive Tract Perforation
摘要
Abstract
Objective:To compare the clinical effect of laparoscopic and open gastrointestinal perforation repair in the treatment of elderly patients with upper digestive tract perforation and to investigate their effect on immune function.Method:A total of 81 cases suffering from gastric and duodenal perforation were enrolled to undergo repair of gastrointestinal perforation,including the laparoscopic group(n=42) and the open surgery group(n=39).The clinical data including operation time,anal exhaust time,hospitalization time,mortality, postoperative VAS pain score,postoperative analgesic agents use rate and incidence of complication were analysed. And the index including preoperative and postoperative 1,3,5,7 days outside week blood CD3+,CD4+, CD8+ T cells and serum CRP,IL-6,TNF-αof two groups were detected.Result:The anal exhaust time, hospitalization time of the laparoscopic group were significantly lower than those of the open surgery group(P<0.05). VAS score postoperative 1,3,5,7 days and postoperative analgesic usage were significantly lower than those of the open surgery group(P<0.05).The incidence of complication of the laparoscopic group was obviously lower than that of the open surgery group.The significant difference had been showed up.The outside week blood CD3+, CD4+,CD8+T cells postoperative 1,3 days in two group existed no significant difference,and CD3+,CD4+ and CD8+ T cells postoperative 5,7 days in the laparoscopic group were significantly higher than those of the open surgery group.Postoperative CRP,IL-6 and TNF-α of the laparoscopic group were significantly lower than those of the open surgery group at the same time point(P<0.05).Conclusion:Laparoscopic repair of gastrointestinal perforation can reduce stress response,and its effect on cellular immune function is little,therefore, laparoscopic repair of gastrointestinal perforation in the treatment of elderly patients with upper digestive tract perforation is better than open surgery.Owing to its obvious minimally invasive advantage,it is available as a first choice in the clinical field.关键词
腹腔镜/胃肠穿孔修补术/老年患者/上消化道穿孔Key words
Laparoscopic/Repair of gastrointestinal perforation/Elderly patients/Upper digestive tract perforation引用本文复制引用
许宇彪,李碧锦,何二松,林昌荣,莫凯迪..腹腔镜与开腹修补术治疗老年上消化道穿孔的对照研究[J].中国医学创新,2016,13(32):28-31,4.基金项目
广西壮族自治区卫生和计划生育委员会自筹经费科研课题 （）
