腹腔镜修补术治疗消化性溃疡急性穿孔40例临床分析

Clinical analysis of laparoscopic suture in the treatment of 40 cases of acute perforation of peptic ulcer

目的探讨腹腔镜胃十二指肠溃疡修补术在消化性溃疡急性穿孔患者的临床应用价值。方法回顾分析我科2010年3月—2011年5月使用腹腔镜行胃十二指肠溃疡修补手术治疗40例消化性溃疡穿孔患者的临床资料。结果 40例患者病理结果均为良性溃疡,手术时间为28～80 min,平均(40.1±17.8)min;术后下床活动时间为14～24 h,平均(16.8±4.7)h;去除胃肠减压时间为14～48 h,平均(19.7±3.5)h;术后镇痛药的使用率为12.5%(5/40);住院时间为4～7 d,平均(5.1±1.4)d;术后均辅以内科抗溃疡药物治疗4～6周,随访6月,无溃疡复发。结论应用腹腔镜胃十二指肠溃疡修补术治疗消化性溃疡穿孔具有安全可靠、疗效好、并发症少、恢复快等优点。

Objective To explore the clinical value of laparoscopic gastric ulcer suture in patients with acute perforation of peptic ulcer. Methods Clinical data of 40 patients with acute perforation of peptic ulcer underwent laparoscopic gastric ulcer suture in our department from March 2010 to May 2011 were retrospectively analyzed. Results Pathologic findings in 40 patients are benign ulcer,operation time is 28-80 minutes,average operation time is（40±17.8） min;postoperative ambulation time is 14-24h,（16.8±4.7）h on average;removal of gastrointestinal decompression time is 14-48h,（19.7±3.5）h on average;the rate of postoperative analgesic use is 12.5%（5/40）;hospitalization time is 4-7d,（5.1±1.4）d on average;anti-ulcer drug for the treatment of 4~6 week,follow-up for 6 months,no ulcer recurrence. Conclusion Laparoscopic gastric ulcer suture has the features of safety,reliability,good curative effect,less complications and quick recovery.