单向倒刺缝线在腹腔镜胃十二指肠溃疡穿孔修补术中应用效果

孙诗琦; 朴倩

单向倒刺缝线在腹腔镜胃十二指肠溃疡穿孔修补术中应用效果

孙诗琦,
朴倩

The application effects of unidirectional barbed suture in laparoscopic repair of perforated gastroduodenal ulcer

摘要

摘要:
目的： 研究单向倒刺缝线对腹腔镜胃十二指肠溃疡穿孔（PGDU）修补术病人胃肠激素、疼痛及免疫功能影响。
方法： 回顾性选取行腹腔镜PGDU修补术病人80例，按照不同缝合方式分为单向倒刺缝线缝合组（单向组）和普通可吸收线缝合组（对照组），各40例；比较2组降钙素基因相关肽（CGRP）、胃蛋白酶原Ⅰ（PGⅠ）、胃动素（MTL）、胃泌素（GAS）水平，并比较2组疼痛数字评价量表（NRS）评分、免疫功能（CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺）和手术相关指标（术中出血量、缝合用时、肠蠕动恢复及住院时间）及并发症（肠梗阻、腹腔感染、切口感染）发生情况。
结果： 2组术前CGRP、PGⅠ、MTL、GAS水平差异均无统计学意义（P ＞ 0.05）；术后1周，2组CGRP、PGⅠ、MTL、GAS均较术前升高（P ＜ 0.05），且单向组CGRP、PGⅠ、MTL、GAS均明显高于对照组（P ＜ 0.01）。2组术后不同时点NRS评分、手术前后免疫功能指标和术中出血量、住院时间差异均无统计学意义（P ＞ 0.05），单向组缝合用时、肠蠕动恢复时间均明显少于对照组（P ＜ 0.01）。单向组并发症总发生率为5.00%（2/40），与对照组的7.50%（3/40）差异无统计学意义（P ＞ 0.05）。
结论： 腹腔镜PGDU修补术采用单向倒刺缝线可进一步缩短缝合用时及肠蠕动恢复时间，对胃肠激素水平的改善更为有效。

Abstract:
Objective To investigate the effects of unidirectional barbed suture on gastrointestinal hormones, pain and immune function in patients treated with laparoscopic repair of perforated gastroduodenal ulcer (PGDU).
Methods A total of 80 patients treated with laparoscopic PGDU repair were retrospectively selected, and divided into the unidirectional barbed suture group (unidirectional group) and common absorbable suture group (control group) according to different suture methods (40 cases each group). The levels of calcitonin gene-related peptide (CGRP), pepsinogen Ⅰ (PGⅠ), motilin (MTL) and gastrin (GAS) were compared between two groups. The Numerical Rating Scale (NRS) scores of pain, immune functions (CD3⁺, CD4⁺, CD8⁺ and CD4⁺/CD8⁺), surgery-related indicators (intraoperative blood loss, suture time, recovery of intestinal peristalsis and hospital stay), and occurrence of complications (intestinal obstruction, abdominal infection and incision infection) were compared between two groups.
Results There was no statistical significance in the levels of CGRP, PGⅠ, MTL and GAS before the operation between two groups (P ＞ 0.05). After 1 week of operation, the levels of CGRP, PGⅠ, MTL and GAS in two groups increased compared with those before the operation (P ＜ 0.05), and the levels of CGRP, PGⅠ, MTL and GAS in the unidirectional group were significantly higher than those in control group (P ＜ 0.01). There was no statistical significance in the NRS scores at different time points after surgery, immune function indicators before and after surgery, intraoperative blood loss and hospital stay between two groups (P ＞ 0.05). The suture time and intestinal peristalsis recovery time in the unidirectional group were significantly shorter than those in control group (P ＜ 0.01). The total incidence of complications in the unidirectional group was 5.00% (2/40), which was not statistically different from 7.50% (3/40) in the control group (P ＞ 0.05).
Conclusions Unidirectional barbed sutures in laparoscopic PGDU repair can further shorten the time of suture and intestinal peristalsis recovery, and is more effective in improving gastrointestinal hormone levels.

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