腹腔镜治疗胃十二指肠溃疡穿孔队列研究

Prospective study of clinical effect on laparoscopic and traditional open surgery in the treatment of gastroduodenal perforation

目的对比分析腹腔镜胃十二指肠穿孔修补术与传统开腹胃十二指肠穿孔修补术的临床疗效。方法将2011年6月至2013年6月笔者所在医院及佛山市第一人民医院收治的胃十二指肠穿孔的患者根据完成的手术分为腹腔镜穿孔修补治疗组与传统开腹修补治疗组,对比分析两组患者的手术时间、术后肛门排气时间、术后镇痛药物使用率、术后住院时间、术后并发症等指标。结果腔镜组完成35例,开腹组完成31例;两组患者均顺利完成手术治愈出院,腹腔镜组无中转开腹手术的病例。开腹组在手术时间低于腹腔镜组(P<0.05),腹腔镜组在住院时间、术后排气时间、术后镇痛药使用率及并发症发生等方面明显低于开腹组(P<0.05)。结论腹腔镜胃十二指肠穿孔修补较开腹手术有明显优势,术后疼痛轻、腹部创伤小、恢复快,值得临床推广。

Objective To compare the clinical efficacy of laparoscopoic gastroduodenal perforation repair and traditional open gastroduodenal perforation repair. Methods This was a prospective study in patients with gastroduodenal perforation in our hospital from June 2011 to June2013. Thirty-five cases underwent laparoscopoic gastroduodenal perforation repair（laparoscopic group）and 31 received open gastroduodenal perforation repair（control group）. The length of hospital stay, operative time,.anal exhaust time,..postoperative usage rate of analgesic drugs and incidence of postoperative complications were analyzed comparatively between two groups. Results All surgical procedures in both group were completed successfully and patients were cured..No case in the laparoscopic group transferred to open operation..Except the average operative time in laparoscopic group was longer than the control group, the length of hospital stay, anal exhaust time, postoperative usage rate of analgesic drugs and incidence of postoperative complications in laparoscopic group were lower than that of the control group. Conclusion Laparoscopic approach in the treatment of gastroduodenal perforation has better clinical effect than open gastroduodenal perforation repair.