腹腔镜胃十二指肠溃疡穿孔修补术临床应用价值的探讨

Study on the Clinical Value of Laparoscopic Repair for Gastroduodenal Ulcer and Perforation

目的评价腹腔镜下胃十二指肠溃疡穿孔修补术的临床价值。方法选择2011年5月至2013年5月于南阳医学高等专科学校第一附属医院就诊的胃十二指肠溃疡穿孔患者97例,按照简单随机原则分为腹腔镜修补组(52例)和开腹修补术组(45例)。观察两组患者手术前后的一般情况及并发症、切口愈合和复发情况。结果腹腔镜修补组患者的手术时间和住院时间分别平均为(38.65±10.45)min和(4.52±2.28)d,短于开腹修补术组的(53.72±10.38)min和(9.52±2.18)d,差异有统计学意义(P<0.05),腹腔镜修补组患者的术中出血量为(40.78±11.12)mL,少于开腹修补术组的(121.56±10.94)mL,差异有统计学意义(P<0.05),腹腔镜修补组患者的术后患者胃肠蠕动恢复时间及下床活动时间分别为(24.72±3.78)h及(10.36±3.44)h,早于开腹修补术组的(32.54±3.76)h及(26.87±3.43)h,差异有统计学意义(P<0.05)。腹腔镜修补组患者的并发症总发生率低于开腹修补术组(P<0.05)。腹腔镜修补组患者的切口愈合率和复发率分别为96.15%和1.92%,开腹修补术组的为91.11%和6.67%,两组比较差异无统计学意义(P>0.05)。结论腹腔镜下胃十二指肠溃疡穿孔修补术对患者的损伤较小。

Objective To analyze the clinical value of laparoscopic repair for gastroduodenal ulcer and perforation.Methods A total of 97 cases of patients with gastroduodenal ulcer and perforation admitted in the First Affiliated Hospital of Nanyang Medical College from May 2011 to May 2013 were randomly divided into laparoscopic repair group（52 cases） and open repair group（45 cases）,patients in the laparoscopic repair group were treated with laparoscopic repair,and patients in the open repair group were treated with open repair.The general conditions before and after surgery and complications,wound healing rate and recurrence rate of the two groups were observed.Results The operation time and duration of hospital stay of the laparoscopic repair group was （38.65 ± 10.45） min and （4.52 ± 2.28） d,significantly shorter than （53.72 ± 10.38） min and （9.52 ± 2.18） d of the open repair group,the difference was statistically significant（P ＜0.05） ; amount of blood loss of the laparoscopic repair group was （40.78 ± 11.12） mL,significantly less than （121.56 ± 10.94） mL of the open repair group,the difference was also statistically significant（P ＜ 0.05） ; time of postoperative gastrointestinal motility recovery and ambulation of the laparoscopic repair group was（24.72 ± 3.78） h and （10.36 ± 3.44） h,significantly earlier than （32.54 ± 3.76） h and （26.87 ±3.43） h of the open repair group,the difference was statistically significant（P ＜ 0.05）.The incidence of complications of the laparoscopic repair group was 5.77％,lower than 20.00％ of the open repair group,the difference was statistically significant（P ＜ 0.05）.The wound healing rate and recurrence rate of the laparoscopic repair group were 96.15％ and 1.92％ respectively,roughly equal to 91.11％ and 6.67％ of the open repair group,and the differences were not statistically significant（P ＞ 0.05）.Conclusion Laparoscopic repair for gastroduodenal ulcer and perforation cause little injury to the patients and has better postoperative effect.