腹腔镜与开腹手术治疗胃十二指肠溃疡穿孔临床效果比较

Clinical effectiveness comparison of laparoscopic and open surgery in treatment of gastric ulcer perforation

目的比较腹腔镜手术与开腹手术治疗胃十二指肠溃疡穿孔的临床效果。方法选择胃十二指肠溃疡穿孔患者92例,按照治疗方法不同分为开腹组和腹腔镜组,各46例。比较两组手术相关指标、术后胃肠动力恢复情况及视觉模拟评分法(VAS)疼痛评分。结果腹腔镜组住院费用高于开腹组(P<0.01),出血量、住院时间均少于开腹组(P<0.01);腹腔镜组24 h、48 h时血清胃泌素(GAS)水平均高于开腹组(P<0.01),肛门排气时间、肠鸣音恢复时间均短于开腹组(P<0.01);腹腔镜组术后第1天、第3天及第7天VAS疼痛评分均低于开腹组(P<0.01)。结论胃十二指肠溃疡穿孔患者采用腹腔镜手术治疗能缩短住院时间、减少出血量,且胃肠动力恢复较快,术后疼痛较轻。

Objective To compare the clinical effectiveness of laparoscopic and open surgery in treatment of gastric ulcer perforation. Methods Ninety-two cases of gastric ulcer perforation were selected in our hospital,and according to the treatment,they were divided into open surgery group and laparoscopic group（ n = 46,each）. Surgery-related indicators,postoperative gastrointestinal power restoration and the postoperative VAS pain score were compared. Results The hospitalization costs of laparoscopic group were higher than those of the open surgery group（ P〈0.01）,the amount of bleeding and length of hospital stay of laparoscopic group were less than those of the open surgery group（ P〈0.01）. GAS level on 24h and 48h of laparoscopic group was higher than that of the open surgery group（ P〈0.01）,flatus and bowel sounds recovery time were shorter than those of the open surgery group（ P〈0.01）. The VAS pain score on the first day,third day and 7th day of the laparoscopic group were lower than those of the open surgery group（ P〈0.01）. Conclusion Laparoscopic surgical treatment of gastric ulcer perforation can shorten hospital stay,reduce the amount of bleeding and relieve postoperative pain with a quick recovery of gastrointestinal motility.