腹腔镜与开腹治疗胃十二指肠急性穿孔的疗效分析

A Retrospective Study Comparing the Laparoscopic versus Open Repair of Perforated Peptic Ulcer

目的比较开放手术与腹腔镜修补术治疗胃十二指肠穿孔的疗效。方法回顾性总结我院2010年6月到2014年6月收治的128例胃十二指肠溃疡穿孔患者,其中68例行腹腔镜胃十二指肠穿孔修补术,60例行传统开放手术方法治疗。结果腹腔镜组的手术时间为(97.7±24.7)min,明显长于传统开放手术组的(76.6±18.8)min(t=3.068,P<0.05);而腹腔镜组的术后住院天数为(4.8±1.2)d,相比传统开放手术(7.1±4.0)d明显缩短(t=2.434,P<0.05),差异有统计学意义。腹腔镜组术后饮食恢复时间为(3.7±1.3)d,开放组为(4.7±2.2)d,两组比较未见明显差异(t=1.726,P>0.05)。结论腹腔镜胃十二指肠溃疡修补术安全有效,能明显缩短患者术后住院时间。

Objective To compare the curative effect of open operation and laparoscopic repair for treatment of gastric and duodenal perforation. Methods From June 2011 to June 2014,128 patients with a clinical diagnosis of perforated peptic ulcer were assigned to undergo either open or laparoscopic repair. Among them,there were 68 cases of laparoscopic repair,and 60 cases of open operation. Results The operation time of laparoscopic repair and traditional open surgery was（ 97. 7 ± 24. 7） min vs.（ 76. 6 ± 18. 8） min,and that of the laparoscopic repair group was significantly longer（ t = 3. 068,P 〈0. 05）. But in contrast,postoperative hospitalization time by laparoscopic group was significantly shorter than the open group,which was（ 4. 8 ±1. 2） days vs.（ 7. 1 ± 4. 0） days（ t = 2. 434,P 〈0. 05）,and the difference was statistically significant. The postoperative diet recovery time had no obvious difference,which was（ 3. 7 ± 1. 3） days vs.（ 4. 7 ± 2. 2） days of the laparoscopic group and the open group（ t = 1. 726,P 〉0. 05）. Conclusion Laparoscopic repair of gastroduodenal ulcer is effective and safe in operation,and can shorten the postoperative hospitalization time.