腹腔镜与开腹手术治疗胃肠穿孔的临床疗效比较

Comparison of clinical efficacy of laparoscopic surgery and laparotomy in treatment of gastrointestinal perforation

目的观察腹腔镜与开腹手术治疗胃肠穿孔的临床疗效,并进行比较分析。方法研究对象为2011年1月～2012年1月期间来本院就诊的胃肠穿孔患者70例,其中38例行腹腔镜手术,设立为治疗组(男22例,女16例),32例行开腹手术(男17例,女15例)。应用统计学方法,比较两组的手术时间、术中出血量、术后排气时间、住院时间及并发症情况。结果两组患者均顺利完成手术,腹腔镜组无感染性休克、肺部感染并发症,无一例死亡。观察组患者并发症例数明显少于对照组,差异具有显著性(P<0.05)。观察组患者的手术时间虽然长于对照组,但术中出血量少于对照组,术后排气时间快,观察组患者住院时间短,两组各项手术观察指标比较,差异具有显著性(P<0.05)。结论腹腔镜手术治疗急性胃十二指肠溃疡穿孔疗效明显优于开腹手术,且并发症少,适合基层医院广泛推广和应用。

Objective To observe and compare the clinical efficacy of laparoscopic surgery and laparotomy in the treatment of gastrointestinal perforation. Methods Seventy patients with gastrointestinal perforation admitted to our hospital from January 2011 to January 2012 were selected as the study subject, of which 38 patients having received laparoscopic surgery were assigned to the observation group （ 22 men and 16 women ） and 32 patients having received laparotomy （ 17 men and 15 women ）were assigned to the control group. The operative time, intraoperative blood loss, postoperative exhaust time, hospital stay and complications of the two groups were compared using statistical methods： Results Both groups of patients went through the surgery successfully. No septic shock, pulmonary infection or death was observed in the observation group. The observation group had significantly less cases of complications than the control group, with significant difference （P 〈 0.05）. The observation group had longer operative time, hut less intraoperative blood loss and shorter postoperative exhaust time and shorter hospital stay than the control group, with significant difference in each indicator （P 〈 0.05）. Conclusion Laparoscopic surgery has significantly better efficacy than laparotomy in the treatment of acute gastroduodenal ulcer perforation and causes few complications, suitable for wide promotion and application in primary hospitals.