腹腔镜下胃十二指肠溃疡穿孔8字缝合修补术的临床观察

Clinical observation of 8 suture repair of laparoscopic gastroduodenal ulcer perforation

目的探讨腹腔镜下胃十二指肠溃疡穿孔8字缝合修补术的临床观察。方法回顾性分析2012年10月至2013年10月入住我院外科的46例胃十二指肠溃疡患者的临床资料，依据手术方法的不同分为两组，观察组采用腹腔镜下8字缝合修补术，对照组采用传统开腹手术，观察两组手术效果、各项指标及并发症。结果两组患者手术均成功，观察组无中转开腹及死亡病例；观察组手术时间（50．5±15．5）min，术中出血量（4．5±1．5）ml，胃肠功能恢复时间（2．5±1．5）d，住院时间（5．5±1．5）d，对照组分别为（95．5±15．5）min，（55．5±10．5）ml，（6．5±2．5）d，（10．5±2．5）d，差异有统计学意义（P〈0．05）；观察组术后并发症2例（8．7％），对照组4例（17．4％），差异有统计学意义（P〈0．05），经对症治疗后均痊愈，随访6个月无复发。结论腹腔镜胃十二指肠溃疡穿孔8字缝合修补术疗效确切，安全性高，利于患者术后恢复，是临床治疗胃十二指肠溃疡穿孔的有效方法。

Objective To investigate the clinical effect of 8 suture repair of laparoscopic gastrodnodenal ulcer perforation. Methods Retrospectively analyzed clinical data of 46 cases of gastroduodenal ulcer perforation in surgical department of our hospital from October 2012 to October 2013, observation group received laparoscopic 8 suture repair, control group received traditional open operation. The operative effect, complications and indexes were observed. Results Operation in all patients of two groups were successful, without conversion and death. In observation group, the average operation time was （50.5 ± 15.5） min, the average amount of bleeding was （4.5 ± 1.5） ml, the average gastrointestinal function recovery time was （2.5 ± 1.5） d, the average hospitalization time was （5.5 ± 1.5） d, those in control group were （95.5 ± 15.5） min, （55.5 ±10.5） ml, （6.5 ± 2.5） d, （10.5 ± 2.5） d respectively, with statistically significant differences （P 〈 0.05）. There were 2 cases （8.7%） of postoperative complications in observation group, 4 cases（17.4%） in control group, with statistically significant difference （P 〈 0.05）; which cured after symptomatic treatment, without recurrence in 6 months of follow-up. Conclusions 8 suture repair of laparoscopie gastroduodenal ulcer perforation has good efficacy and high safety, conducive to postoperative recovery, which is an effective method for clinical treatment of gastroduodenal ulcer perforation.