对称三孔法腹腔镜袖状胃切除术中连续使用Bougie管的临床价值

Clinical value of continuous Bougie tube use in symmetrical three-port laparoscopic sleeve gastrectomy

    摘要
  • 摘要:
    探讨对称三孔法腹腔镜袖状胃切除术（LSG）中连续使用Bougie管的临床价值。
    采用回顾性队列研究。收集2021年10月至2024年10月山西医科大学第一医院收治的105例行对称三孔法LSG患者的临床资料；男57例,女48例；年龄为27（19~59）岁。105例患者中,52例术中连续使用Bougie管,设为连续组；53例术中间断使用Bougie管,设为间断组。观察指标：（1）手术情况。（2）并发症情况。正态分布的计量资料组间比较采用独立样本t检验。偏态分布的计量资料组间比较采用Mann‑Whitney U检验。计数资料组间比较采用χ²检验。
    （1）手术情况。105例患者均顺利施行对称三孔法LSG。连续组和间断组患者手术时间分别为（57±4）min和（76±4）min,术中出血量分别为（26±6）mL和（59±9）mL,术后首次下床时间分别为（218±8）min和（299±9）min、术后首次肛门排气时间分别为（19.6±2.9）h和（25.8±2.8）h、术后6 h活动视觉模拟疼痛评分分别为（2.3±1.0）分和（4.7±1.0）分、术后住院时间分别为（1.5±0.6）d和（3.1±0.9）d,两组比较,差异均有统计学意义（t=26.92、22.31、48.91、11.15、13.25、10.21,P<0.05）。（2）并发症情况。105例患者术后均无严重并发症。连续组和间断组患者术后2 h发生恶心和呕吐例数分别为26例和38例,两组比较,差异有统计学意义（χ²=5.19,P<0.05）。
    与间断使用Bougie管相比,对称三孔法LSG中连续使用Bougie管可以缩短手术时间和术后住院时间,减少术中出血量,降低术后疼痛,患者术后恢复更快,术后并发症更少。

     

    Abstract:
    Objective To investigate the clinical value of continuous Bougie tube use in symmetrical three-port laparoscopic sleeve gastrectomy (LSG).
    Methods The retrospective cohort study was conducted. The clinical data of 105 patients who underwent symmetrical three-port LSG at The First Hospital of Shanxi Medical University from October 2021 to October 2024 were collected. There were 57 males and 48 females, aged 27(range, 19-59)years. Of the 105 patients, 52 cases with continuous Bougie tube use during the surgery were divided into continuous group, while 53 cases with intermittent Bougie tube use were divided into intermittent group. Observation indicators: (1) surgical situations; (2) complications. Comparison of measurement data with normal distribution between groups was conducted using the independent sample t test. Comparison of measurement data with skewed distribution between groups was conducted using the Mann-Whitney U test. Comparison of count data between groups was conducted using the chi-square test.
    Results (1) Surgical situations. All 105 patients underwent symmetrical three-port LSG. The operation time was (57±4)minutes versus (76±4)minutes for the continuous group and the intermittent group, volume of intraoperative blood loss was (26±6)mL versus (59±9)mL, time to first out-of-bed activities was (218±8)minutes versus (299±9)minutes, time to first anal exhaust was (19.6±2.9)hours versus (25.8±2.8)hours, visual analogue scale score for pain at 6 hours postoperatively was 2.3±1.0 versus 4.7±1.0, and duration of postoperative hospital stay was (1.5±0.6)days versus (3.1±0.9)days for the two groups, respectively. There were significant differences in the above indicators between the two groups(t=26.92, 22.31, 48.91, 11.15, 13.25, 10.21, P<0.05). (2) Complications. No severe postopera-tive complication occurred in any of the 105 patients. There were 26 cases and 38 cases with nausea and vomiting at 2 hours postoperatively, showing a significant difference between them (χ²=5.19, P<0.05).
    Conclusion Compared to intermittent Bougie tube use, continuous Bougie tube use during symmetrical three-port LSG can significantly shorten operation time and duration of postoperative hospital stay, reduce intraoperative bleeding and postoperative pain, accelerate recovery of patients, and lower the incidence of complications.

     

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