微创胃十二指肠穿孔修补术与传统开腹术治疗胃穿孔患者临床效果的比较

Efficacy of laparoscopy vs laparotomy for gastroduodenal perforation

目的:比较腹腔镜与传统开腹胃十二指肠穿孔修补术的临床疗效.方法:将我院收治的160例胃十二指肠穿孔患者随机分为观察组和对照组各80例,对照组行传统胃十二指肠穿孔修补术,观察组在腹腔镜下行胃十二指肠穿孔修补术.比较两组患者术后总有效率、术后胃肠动力恢复时间以及并发症发生情况.结果:观察组术后总有效率为93.75%,明显高于对照组(78.75%),两组相比差异具有统计学意义(χ2=9.486,P<0.05).观察组手术时间、术中出血量明显少于对照组,胃肠功能恢复时间、术后住院时间也较对照组明显缩短,两组间相比差异具有统计学意义(P<0.05);观察组术后肛门排气时间、肠鸣音恢复时间、胃肠减压解除时间显著少于对照组(P<0.05).观察组切口感染、腹腔脓肿发生率显著低于对照组,两组间相比差异具有统计学意义(P<0.05).结论:腹腔镜下胃十二指肠穿孔修补术具有微创、疗效确切、胃肠动力恢复速度快、并发症少等优点,优于传统开腹术,值得临床推广.

AIM： To compare the efficacy of laparoscopy vs laparotomy in the management of gastroduodenal perforation.METHODS： One hundred and sixty patients with gastroduodenal perforation treated at our hospital were randomly and equally divided into either an observation group or a control group. The control group underwent conventional gastroduodenal perforation repair, while the observation group underwent laparoscopic gastroduodenal perforation repair. The total effective rate, time to gastrointestinal motility recovery and complications were compared between the two groups.RESULTS： The total effective rate was significantly higher in the observation group than in the control group（93.75% vs 78.75%, χ^2 = 9.486, P 0.05）. The operative time and bleeding volume were significantly less, and the time to gastrointestinal function recovery and postoperative hospital stay were significantly shorter in the observation group than in the control group（P 0.05）. In addition, the observation group had significantly shorter anal exhaust time, time to recovery of bowel sounds, and decompression time than the control group（P 0.05）. The rates of wound infection and abdominal abscess were significantly lower in the observation group than in the control group（P 0.05）.CONCLUSION： Laparoscopic gastroduodenal perforation repair is minimally invasive, more effective and has less complications than traditional open surgery.