腹腔镜与开腹手术用于胃十二指肠溃疡穿孔修补术的疗效及医疗费用比较

Comparison of effects and medical cost between laparoscopy and laparotomy for gastroduodenal ulcer perforation

目的对比分析腹腔镜与开腹手术修补胃十二指肠溃疡穿孔在手术疗效和医疗费用方面的差异。方法将我院2003年5月～2008年5月急诊行消化性溃疡穿孔修补术的62例分为腹腔镜手术组（28例）和开腹手术组（34例），比较两组的临床疗效和医疗费用指标。结果腹腔镜手术组在手术时间、术中出血量、术后第2d白细胞计数、病人术后肛门排气时间、切口感染情况、住院时间、住院费用等方面均显著低于开腹手术组（P〈0．05）；而术后镇痛药使用例次腹腔镜手术组与开腹手术组相比较，有非常显著性差异（P〈0．01）。结论腹腔镜下行胃十二指肠溃疡穿孔修补术在手术疗效及医疗费用方面均优于开腹手术者。

Objective To compare differences in clinical effects and medical cost of laparoscopy and laparotomy for gastroduodenal ulcer perforation. Methods 62 cases with gastroduodenal ulcer perforation from May 2003 to May 2008 performed repaired operation were divided into two groups, 28 cases treated by laparoscopy and 34 cases treated by laparotomy. Clinical effects and medical cost were compared between the two groups. Results All indexes of operative time, intraoperative bleeding, WBC count on the day after operation,discharging gas time after operation,wound infection, length of stay and cost of hospitalization were lower in laparoscopy group than in laparotomy group, the difference is significant（P〈0. 05）. While there was highly significant difference in frequency of using ano dyne after operation between the two groups（P〈0. 01 ）. Conclusion Laparoscopic operation is superior to laparotomy for perforated peptic ulcer in clinical effects and medical cost.