腹腔镜与开腹胃十二指肠溃疡穿孔修补术的比较

Comparative study of curative effect on the repair of gastroduodenal ulcer perforation between laparoscopic and open abdominal method

目的比较腹腔镜与开腹手术治疗胃十二指肠溃疡穿孔的临床疗效。方法回顾性分析80例腹腔镜胃十二指肠溃疡穿孔修补术和78例开腹胃十二指肠溃疡修补术患者的临床资料,比较分析两种术式的手术时间、术后下床时间、住院时间、住院费用、失血量、术后补充使用镇痛药例数、切口美观指数及术后并发症等情况。结果腹腔镜组80例修补术均获成功,无一例中转开腹。与开腹手术组比较,术后下床时间、住院时间、失血量;术后使用镇痛药例数、切口美观等均优于开腹手术组。术后并发症腹腔镜组除了一例皮下气肿,其他如切口感染、腹腔残余脓肿、肺部感染、肠粘连等发生率均低于开腹组差异有统计学意义(P<0.05)。两组手术在手术时间和住院费用差异无统计学意义。结论腹腔镜胃十二指肠溃疡穿孔修补术与开腹手术比具有创伤小、康复快、住院时间短、并发症少、切口美观等优点。

Objective To compare the effect of laparoscopic and open surgery in the treatment of gastric ulcer perforation. Methods A retrospective data of patients with gastric ulcer perforation was analyzed, in which 80 cases underwent laparoscopic operation and 78 cases underwent open surgery. The clinical effects were compared between two groups. Results The operation in laparoscopic group was successfully performed and no case was converted to open surgery. The curative effect of laparoscopic group was superior to that of open operation in hospital stay, postoperative off-bed time, blood loss, and the incision looking. One case of subcutaneous emphysema was found in laparoscopic group. Incision infection, abdominal abscess, lung infection, intestinal adhesion in laparoscopic group were lower than in open operation group. There was no significant difference in operative time and hospital costs between two groups. Conclusion Compared to open surgery, laparoscopic gastroduodenal ulcer perforation repair surgery has advantages in trauma, recovery time, hospital stay, complications rate and incision looking.