腹腔镜与开腹胃十二指肠溃疡穿孔修补术的对比研究与护理

Comparative study and nursing of iaparoscopy and laparotomy in the treatment of gastroduodenal ulcer perforation

目的：对两种胃十二指肠溃疡穿孔修补方法进行比较，为临床提供参考。方法选择来胶州市人民医院接受治疗的176例胃十二指肠溃疡穿孔患者，根据患者本人及家属意愿分别选择腹腔镜手术治疗和开腹治疗。观察两组手术时间、出血量、切口大小和术后镇痛次数、术后肠蠕动恢复时间、并发症和住院时间。结果腹腔镜组手术时间明显长于开腹组，差异有统计学意义（P﹤0.05）。腹腔镜组出血量、切口尺寸、镇痛次数、肠蠕动恢复时间、并发症发生率和住院时间明显低于开腹组，差异有统计学意义（P﹤0.05）。腹腔镜组切口感染、肺部感染发生率和肠粘连发生率明显低于开腹组，差异有统计学意义（P﹤0.05）。结论与开腹手术比较，腹腔镜胃十二指肠溃疡穿孔修补术具有更好的疗效，是一种安全有效的手术方法。

Objective To compare the efficacy of laparoscopy and laparotomy on gastroduodenal ulcer perforation,and provide references for clinics. Methods The 176 patients with gastroduodenal ulcer perforation were divided into the laparoscopic group and laparotomy group,according to the wills of the patients or their family members. The operative time,intra-operative blood loss,incision size,incidence of complications,postoperative recovery time of bowl function,hospital stay were observed. Results The operative time was significantly longer in laparoscopic group than that in laparotomy group, there was significant difference（P﹤0. 05）. The intraoperative blood loss,incision size,the postoperative recovery time of intestinal peristalsis,incidence of complications and hospital stay were significantly lower in laparoscopic group than that in laparotomy group,there were significant differences（P﹤0. 05）. The incidences of wound infection,pulmonary infection and laparoscopic intestinal viscosity were significantly lower in laparoscopic group than those in laparotomy group,there were significant differences（ P﹤0. 05）. Conclusions Compared with the laparotomy,the laparoscopic repairment of gastroduodenal ulcer perforation has better effect,and is one safe and effective surgery method.