Effect of laparoscopic neoplasty in treatment of gastric and duodenal ulcer perforation and its influence on immune function / 新乡医学院学报

ABSTRACT

Objective To investigate the effect of laparoscopic neoplasty in the treatment of gastric and duodenal ulcer perforation and its influence on immune function. Methods A total of 98 patients with gastric and duodenal ulcer perforation were selected from February 2010 to February 2017 in the Second People's Hospital of Zhengzhou City. The patients were di-vided into observation group and control group according to operative method,49 cases in each group. The operation time,intra-operative bleeding volume,anal exhaust time and hospitalization time were recorded in the two groups. The postoperative pain of all patients were evaluated by visual analogue scales(VAS)on the 1st ,2nd and 7th day after operation. The levels of serum pro-calcitonin(PCT),CD 3+,CD 4+,CD 8+ and natural killer(NK)cell were detected at the time points of 30 min before operation and the 1st ,2nd and 7th day after operation respectively. Results The intraoperative bleeding volume in the observation group was significantly less than that in the control group(P < 0. 05),the anus exhaust time and the hospitalization time in the obser-vation group were significantly shorter than those in the control group(P < 0. 05),and the operation time in the observation group was significantly longer than that in the control group(P < 0. 05). The VAS score in the observation group was signifi-cantly lower than those in the control group on the 1st ,2nd and 7th day after operation(P < 0. 05). The incidence of postopera-tive complication in the observation group and the control group was 6. 12％(3 / 49)and 26. 53％(13 / 49)respectively,the in-cidence of postoperative complication in the observation group was significantly lower than that in the control group(χ2 =13. 652,P < 0. 05). There was no significant difference in serum CD 3+,CD 4+,CD 8+,NK cell and PCT levels between the two groups before operation(P > 0. 05). The levels of serum CD 3+,CD 4+,CD 8+ and NK cell on the 1st and 2nd day after operation were significantly lower than those before operation,and the PCT level on the 1st and 2nd day after operation was significantly higher than that before operation in the control group(P < 0. 05). The levels of serum CD 3+,CD 8+ and NK cell on the 7th day after operation were significantly lower than those before operation in the control group(P < 0. 05). There was no significant difference in the levels of serum CD4 + and PCT between the 7th day after operation and before operation in the control group (P > 0. 05). The levels of serum CD 3+,CD 4+,CD 8+ and NK cell on the 1st day after operation were significantly lower than those before operation,and the PCT level on the 1st day after operation was significantly higher than that before operation in the observation group(P < 0. 05). There was no significant difference in serum CD 3+,CD 4+,CD 8+,NK cell and PCT levels be-tween the 2nd ,7th day after operation and before operation in the observation group(P > 0. 05). The levels of serum CD 3+,CD4 +,CD 8+ and NK cell in the observation group were significantly higher than those in the control group on the 1st ,2nd and 7th day after operation(P < 0. 05). The serum PCT level in the observation group was significantly lower than that in the control group on the 1st and 2nd day after operation(P < 0. 05). There was no significant difference in serum PCT level between the two groups on the 7th day after operation(P > 0. 05). Conclusion Laparoscopic neoplasty for gastric and duodenal ulcer perfora-tion has less traumatic and less influence on the immune function of patients. It is beneficial to the recovery of postoperative body function,and can reduce postoperative complications. The laparoscopic repair is effective in the treatment of perforation of gastric and duodenal ulcer. It is beneficial to the recovery of reduce postoperative complications.Objective To investigate the effect of laparoscopic neoplasty in the treatment of gastric and duodenal ulcer perforation and its influence on immune function. Methods A total of 98 patients with gastric and duodenal ulcer perforation were selected from February 2010 to February 2017 in the Second People's Hospital of Zhengzhou City. The patients were di-vided into observation group and control group according to operative method,49 cases in each group. The operation time,intra-operative bleeding volume,anal exhaust time and hospitalization time were recorded in the two groups. The postoperative pain of all patients were evaluated by visual analogue scales(VAS)on the 1st ,2nd and 7th day after operation. The levels of serum pro-calcitonin(PCT),CD 3+,CD 4+,CD 8+ and natural killer(NK)cell were detected at the time points of 30 min before operation and the 1st ,2nd and 7th day after operation respectively. Results The intraoperative bleeding volume in the observation group was significantly less than that in the control group(P < 0. 05),the anus exhaust time and the hospitalization time in the obser-vation group were significantly shorter than those in the control group(P < 0. 05),and the operation time in the observation group was significantly longer than that in the control group(P < 0. 05). The VAS score in the observation group was signifi-cantly lower than those in the control group on the 1st ,2nd and 7th day after operation(P < 0. 05). The incidence of postopera-tive complication in the observation group and the control group was 6. 12％(3 / 49)and 26. 53％(13 / 49)respectively,the in-cidence of postoperative complication in the observation group was significantly lower than that in the control group(χ2 =13. 652,P < 0. 05). There was no significant difference in serum CD 3+,CD 4+,CD 8+,NK cell and PCT levels between the two groups before operation(P > 0. 05). The levels of serum CD 3+,CD 4+,CD 8+ and NK cell on the 1st and 2nd day after operation were significantly lower than those before operation,and the PCT level on the 1st and 2nd day after operation was significantly higher than that before operation in the control group(P < 0. 05). The levels of serum CD 3+,CD 8+ and NK cell on the 7th day after operation were significantly lower than those before operation in the control group(P < 0. 05). There was no significant difference in the levels of serum CD4 + and PCT between the 7th day after operation and before operation in the control group (P > 0. 05). The levels of serum CD 3+,CD 4+,CD 8+ and NK cell on the 1st day after operation were significantly lower than those before operation,and the PCT level on the 1st day after operation was significantly higher than that before operation in the observation group(P < 0. 05). There was no significant difference in serum CD 3+,CD 4+,CD 8+,NK cell and PCT levels be-tween the 2nd ,7th day after operation and before operation in the observation group(P > 0. 05). The levels of serum CD 3+,CD4 +,CD 8+ and NK cell in the observation group were significantly higher than those in the control group on the 1st ,2nd and 7th day after operation(P < 0. 05). The serum PCT level in the observation group was significantly lower than that in the control group on the 1st and 2nd day after operation(P < 0. 05). There was no significant difference in serum PCT level between the two groups on the 7th day after operation(P > 0. 05). Conclusion Laparoscopic neoplasty for gastric and duodenal ulcer perfora-tion has less traumatic and less influence on the immune function of patients. It is beneficial to the recovery of postoperative body function,and can reduce postoperative complications. The laparoscopic repair is effective in the treatment of perforation of gastric and duodenal ulcer. It is beneficial to the recovery of reduce postoperative complications.