腹腔镜与小切口开腹手术治疗胃十二指肠溃疡穿孔的对比研究

Comparative study of laparoscopy and mini-incision laparotomy in the treatment of perforated gastroduodenal ulcer

目的:对比腹腔镜与小切口开腹手术治疗胃十二指肠溃疡穿孔的临床效果。方法:将2006年3月至2012年3月收治的62例胃十二指肠溃疡穿孔患者随机平均分为两组,对照组患者行小切口开腹胃十二指肠溃疡穿孔修补术,观察组患者行腹腔镜胃十二指肠溃疡穿孔修补术。对比分析两组患者手术情况及术后康复情况、镇痛情况、住院时间、并发症。结果:两组患者手术时间差异无统计学意义(P>0.05),观察组术中出血量明显减少(P<0.01),下床活动时间、排气时间及住院时间明显缩短(P<0.01);镇痛剂应用比例显著降低(P<0.05)。观察组术后未发生切口感染、腹腔残余脓肿,显著优于对照组(P<0.05);穿孔复发率及肺部感染率两组差异无统计学意义(P>0.05)。结论:胃十二指肠溃疡穿孔行腹腔镜修补术具有患者创伤小、康复快、不良反应少等优点,值得推广应用。

Objective：To compare the clinical effect of laparoscopy and mini-incision laparotomy in the treatment of perforated gastroduodenal ulcer.Methods：Sixty-two patients with perforated gastroduodenal ulcer,who visited the second People＇s hospital of Yiwu from Mar.2006 to Mar.2012,were equally and randomly divided into observation group and control group.Cases in observation group received laparoscopic operation to repair perforated gastroduodenal ulcer,and cases in control group received mini-incision laparotomy to repair perforated gastroduodenal ulcer.The operation condition,recovery after operation,analgesia after operation,hospital stay and complications after operation in both groups were compared between the 2 groups.Results：The operation time was not significantly different between the 2 groups（P0.05）,the blood loss in observation group was significantly decreased compared with control group（P0.01）,and off-bed time,exhaust time and hospital stay in observation group were significantly shorter compared with control group（P0.01）.The rate of analgesia after operation in observation group was significantly decreased compared with control group（P0.05）,and rate of infectious incision and residual abscess in abdominal cavity in observation group was significantly decreased compared with control group（P0.05）,but the rate of perforated recurrence and pulmonary infection were not significantly different between both groups（P0.05）.Conclusions：Laparoscopic operation for the repair of perforated gastroduodenal ulcer has the advantages of small trauma,rapid recovery and few adverse reactions,and it is worthy to be recommended in clinic.