【摘要】 目的 观察腹腔镜下微创修补术对胃穿孔术后胃肠动力的影响分析。方法 将在医院（2018年1月1日—2020年12月30日）收治胃穿孔患者60例拟手术治疗，以随机数字表法分组，每组各30例患者，其中30例实施传统开腹手术为对照组，另30例患者则实施腹腔镜下微创修补术治疗为研究组。比较围手术期相关指标、胃肠动力指标，术前、术后3 d的机体应激指标与胃泌素分泌水平及疼痛评分，统计围手术期不良事件发生率。结果 研究组患者的手术时间、首次下床时间与住院时长均短于对照组，而术中出血量则少于对照组，差异有统计学意义（P <0.05）。研究组患者的胃肠动力指标恢复时间均明显的短于对照组，差异有统计学意义（P <0.05）。两组患者术前机体应激指标与胃泌素分泌水平及疼痛评分相比，差异无统计学意义（P> 0.05）。两组患者术后3 d时机体应激指标中SOD指标与胃泌素分泌水平则较术前提升，研究组高于对照组，而术后3 d的机体应激指标中MDA指标及疼痛评分均较术前降低，研究组低于对照组，差异有统计学意义（P <0.05）。研究组患者围手术期不良事件发生率低于对照组，差异有统计学意义（P <0.05）。结论 在腹腔镜下微创修补术对胃穿孔术后，相比较于传统修补术，可明显地缩短手术与首次下床时间，减少术中的出血量，减轻对机体的应激反应影响，改善胃泌素分泌，降低对胃肠动力的影响，减少不良事件的发生，有效地缩短住院时间。更多还原

【Abstract】 Objective To observe the effect of laparoscopic minimally invasive repair on gastrointestinal motility after gastric perforation.Methods A total of 60 patients with gastric perforation in our hospital(from January 1, 2018 to December 30, 2020) were randomly divided into two groups, 30 patients in each group, 30 patients in the control group were treated with traditional open surgery, and 30 patients in the study group were treated with laparoscopic micro invasive repair.The perioperative related indexes, gastrointestinal motility recovery indexes, body stress indexes, gastrin secretion level and pain score before and 3 days after operation were compared between the two groups. The incidence of adverse events during the perioperative period was counted. Results The operation time, the first time out of bed and the length of hospital stay of the study group were shorter than those of the control group, and the intraoperative blood loss was less than that of the control group, the difference was statistically significant(P < 0.05). The recovery time of gastrointestinal motility indexes in the study group was significantly shorter than that in the control group,the difference was statistically significant(P < 0.05). There was no statistically significant difference(P > 0.05) between the two groups in preoperative stress index, gastrin secretion level and pain score. The levels of SOD and gastrin in the stress indexes of the two groups at 3 days after operation were higher than those before operation, and the levels of MDA and pain score in the stress indexes of the study group were lower than those of the control group at 3 days after operation,the difference was statistically significant(P < 0.05). The incidence of perioperative adverse events in the study group was lower than that in the control group, the difference was statistically significant(P < 0.05).Conclusion Compared with traditional repair, laparoscopic minimally invasive repair of gastric perforation can significantly shorten the operation time and the first time out of bed, reduce the amount of bleeding, reduce the impact of stress response on the body, improve gastrin secretion, reduce the impact on gastrointestinal motility, reduce the occurrence of adverse events, and effectively shorten the length of hospital stay.更多还原