腹腔镜手术与传统开腹修补术治疗胃十二指肠溃疡穿孔疗效比较

Comparison of clinical effect of perforated gastroduodenal ulcer treatment by laparoscopy and traditional open repair

目的比较腹腔镜手术与传统开腹修补术治疗胃十二指肠溃疡穿孔的临床效果。方法70例十二指肠溃疡穿孔患者根据不同术式分为腹腔镜组和开腹组，腹腔镜组患者采用腹腔镜修补胃十二指肠溃疡穿孔，开腹组患者按照传统开腹术式修补胃十二指肠溃疡穿孔，观察并记录两组手术时间、术中出血量以及术中、术后并发症发生情况。结果腹腔镜组术中出血量（6．7±1．1）m1、术后排气时间（35．7±5．9）h、住院总时间（6．2±1．4）d，均明显少于开腹组的（67．1±14．9）ml、（58．1±12．2）h、（13．8±2．7）d（t=35．94、11．75、21．48，均P〈0．05），两组手术时间[（42．7±11．8）min与（48．3±13．7）min]差异无统计学间意义（t=0．776，P〉0．05）。腹腔镜组患者无一例并发症发生（0．00％），开腹组有7例并发症发生（22．73％），其中切口感染6例、切口出血3例、肠梗阻1例，所有患者经及时处理，均康复出院。结论利用腹腔镜术式修补胃十二指肠溃疡穿孔创伤小，痛苦减轻，术后并发症少，恢复时间短，安全有效，值得临床推广。

Objective To compare the clinical effects of perforated gastroduodenal ulcer treatment by lapa- roscopy and traditional open repair. Methods 70 cases of patients with perforated diagnosed as gastroduodenal ulcer were selected and divided into laparoscopic group and open group by different operation type. Laparoscopy was used in laparoscopic group,while traditional open repair was used in open group. The mean time in operation, intraoperative blood loss and intraoperative and postoperative complications were observed and recorded. Results There was no difference in operative mean time between the two groups（P 〉 0.05 ） ,but intraoperative blood loss was less in laparo- scopic group than that in open group （ P 〈 0.05 ）, exhaust time and hospitalization time in laparoscopic group were shorter than that in open group （P 〈 0. 05 ） , and no complication was found in laparoscopic group（0. 00% ） , while 10 cases in open group （ 22.73 % ）, the rate in the former group was lower than that in the latter group （ P 〈 0. 05 ）. Conclusion Using laparoscopy to repair perforated gastroduodenal ulcer had little trauma,less pain, less complica- tion, shorter recover time and safe. It is worthy of clinical.