腹腔镜胃十二指肠溃疡穿孔修补术的临床研究

The clinical studies on laparoscopic gastric ulcer perforation repair

目的对比分析腹腔镜胃十二指肠溃疡穿孔修补术与开腹溃疡穿孔修补术的临床手术效果。方法 100例胃十二指肠溃疡穿孔患者中行腹腔镜胃十二指肠溃疡穿孔修补术的50例,为腹腔镜组,行开腹胃十二指肠溃疡穿孔修补术的50例患者作为开腹组,比较两组患者的手术时间、术中出血量、术后下床活动时间、住院时间、术后疼痛评分、并发症及复发情况。结果腹腔镜组患者的手术时间、术后下床活动时间、平均住院时间均短于开腹组(P<0.05);且腹腔镜组的术中出血量为(10.37±1.24)mL,也明显少于开腹组(P<0.05);随着术后恢复时间的延长,两组患者术后疼痛程度逐渐降低,术后当日两组患者的疼痛评分比较差异无显著性,而术后第1天和术后第3天两组患者的疼痛评分不同疼痛程度组间分别比较,存在显著性差异(P<0.05)。术后12个月,两组复发率分别为12%、26%,组间比较存在显著性差异(P<0.05)。结论腹腔镜胃十二指肠溃疡穿孔修补术与开腹溃疡穿孔修补术相比具有手术时间短、术中出血量少、并发症少、疼痛程度轻、住院时间短、术后复发率低等优点,值得广泛推广和应用。

Objective To comparative the clinical effect of laparoscopic gastric ulcer perforation repair versus open re- pair of perforated ulcer surgery. Methods A total of 100 patients with gastric ulcer perforation, 50 patients as laparo- scopic group, 50 patients as the laparotomy group, operative time,blood loss,postoperative ambulation,hospitalization time, pain score ,the incidence of complications,ulcer relapsed were compared. Results The operative time, postopera- tive ambulation time, average length of stay was shorter in the laparotomy group than the control group, the difference was statistically significant （P 〈0. 05）; blood loss of laparoscopic group was （10.37_＋1.24） mL,was significantly shorter than the group group （P 〈0. 05）; With prolonged postoperative recovery time, postoperative pain levels decreased, the day after the pain scores between the two groups had no significant difference, whereas on the first postoperative day af- ter the first three days, the two groups of patients with different degree of pain pain scores between groups were com- pared, there was a significant difference （P 〈0. 05）.after 12 months, the recurrence rate between two groups there was a significant difference （P 〈0. 05）. Conclusion Laparoscopic gastric ulcer perforation repair and open ulcer perforation repair, compared with shorter operative time, less blood loss, fewer complications, mild pain, shorter hospital stay, post- operative recurrence rate and low, should be popularized and applied.