腹腔镜治疗胃十二指肠溃疡穿孔15例的临床疗效观察

Observation on clinical curative effects of 15 patients with perforation of gastroduodenal ulcer treated by laparoscopic surgery

目的观察腹腔镜修补术治疗急性胃十二指肠溃疡穿孔的临床疗效。方法 15例患者均经腹腔镜行穿孔缝合大网膜覆盖修补,术后患者进行消化性溃疡内科常规治疗,如持续胃肠减压、根除幽门螺杆菌、抗感染、补液、抑酸等。结果 15例患者经过治疗后,病情得到了控制,身体恢复良好,切口均甲级愈合,无手术并发症发生。术后3个月15例获得随访。复查胃镜13例无溃疡复发,2例仍然发现有浅表性溃疡。结论腹腔镜修补术治疗急性胃十二指肠溃疡穿孔具有术中出血少、探查范围广、术后切口疼痛轻、下床活动早、胃肠功能恢复快、住院时间短等优点,是一项安全、可靠的外科技术,具有良好的临床应用价值。

Objective To observe the clinical curative effects of laparoscopic repair in the treatment of acute gastric and duodenum perforation （AGDP）. Methods Fifteen patients with AGDP were performed on suture repair of the greater omentum covering by laparoscope. The conventional therapies in gastric ulcer like continuous gastrointestinal decompression, helicobacter pylori elimination, anti-inflammation, fluid replacement, and anti-acid were applied to postoperative patients. Results After treatment, the conditions of 15 cases were controlled and well recovered. There was no complication during surgery and incisions were all healed in class-A levels. Gastroscopy in follow up after 3 months showed that no recurrent ulcer in 13 cases and superficial ulcer in 2 cases. Conclusion In the treatment of AGDP by laparoscopic repair, it has some advantages of little hemorrhage, wide exploration scope, mild pain of incision after operation, early out of bed activity, rapid recovery of gastrointestinal functions, and short hospitalization time, which is a reliable and safe surgical technique with a satisfying clinical value.