腹腔镜与开腹胃十二指肠溃疡穿孔修补术的对比研究

Laparoscopic versus open repair of gastroduodenal ulcer perforation

目的:比较腹腔镜与开腹胃十二指肠溃疡穿孔修补术的疗效。方法:回顾分析我院确诊为胃十二指肠溃疡穿孔52例患者的临床资料,其中28例行腹腔镜胃十二指肠溃疡穿孔修补术(腹腔镜组),24例行开腹胃十二指肠溃疡穿孔修补术(开腹组),比较两组手术时间、术中出血量、并发症发生率、术后肠道功能恢复时间、术后体温及住院时间。结果:腹腔镜组与开腹组手术时间分别为(78.75±25.178)min和(97.50±26.029)m in(P<0.05),术中出血量分别为(43.21±12.488)ml和(77.50±21.518)m l(P<0.001),并发症分别为3例和8例(P<0.05),术后体温>38℃分别为5例、11例,术后肠蠕动恢复时间分别为(2.33±0.816)d和(3.75±1.035)d(P<0.001),术后住院分别为(6.83±1.169)h和(10.00±1.309)h(P<0.001)。结论:胃十二指肠溃疡穿孔患者行腹腔镜手术与开腹手术一样安全,且具有创伤小、康复快、住院时间短等优点。

Objective：To compare the therapeutic effect between laparoscopic repair of gastroduodenal ulcer perforation and open procedures. Methods ：The clinical data of 52 cases were retrospectively reviewed. 28 cases were performed laparoscopically, and 24 cases underwent open procedure. The operative time,intraoperative blood loss,incidence of complications, postopertive recovery time of bowel movement, postoperative body temperature and hospitalization of the two groups were compared respectively. Results：The operative time was（ 78. 75 ± 25. 178 ） rain in laparoscopic group vs. （97.50 ± 26. 029） rain in open group （ P 〈 0. 05 ）. The intraoperative blood loss was （43.21 ± 12. 488 ）ml vs. （77.50 ± 21.518 ） ml （P 〈 0. 001 ）, the postoperative hospitalization was （6. 83 ± 1. 169 ） days vs. （10. 00 ± 1. 309）days （P 〈 0. 001 ）,the postoperative recovery time of bowel function was （2. 33 ± 0. 816） hours vs. （3.75 ± 1. 035） hours（P 〈 0. 001 ） , and the postoperative complications were observed in 3 cases vs. 8 cases, the postoperative body temperature （ 〉 38℃ ） were observed in 5 cases vs. 11 cases. Conclusions：The laparoscopic operation for gastroduodenal ulcer perforation can be considered as safe as the open operation and has advantages such as shorter operative time,rapid recovery and minimal incion.