摘要
目的:对比分析腹腔镜与开腹胃十二指肠溃疡穿孔修补术的临床效果。方法:选取2010年1月至2014年12月行腹腔镜胃十二指肠溃疡穿孔修补术的41例患者作为实验组,同期行传统开腹手术的38例患者作为对照组,对比分析两组手术时间、出血量、术后疼痛、术后首次下床活动时间、术后肛门排气时间、术后住院时间及术后并发症发生率等相关指标。结果:两组手术均获成功。手术时间、出血量、术后疼痛、术后首次下床活动时间、术后肛门排气时间、术后住院时间两组相比差异均有统计学意义(P<0.05)。术后并发症发生率两组相比差异无统计学意义(P>0.05)。结论:腔镜胃十二指肠溃疡穿孔修补术临床效果更明显,具有手术时间短、出血量少、术后疼痛轻、下床活动时间早、排气时间短、住院时间短等优点,镜下不能完成的操作,亦可指导术者选择切口位置,以更小的切口完成手术,值得临床推广应用。
Objective： To compare the clinical effects of laparoscopic vs. open procedure for gastric duodenal ulcer perforation.Methods： Clinical data of 79 patients with gastric duodenal ulcer perforation from Jan. 2010 to Dec. 2014 were retrospectively analyzed,including operative time,blood loss,pain score,first ambulation time,first flatus time,postoperative hospital stay and complications.There were 41 patients who underwent laparoscopic procedures and 38 patients who underwent open procedures. Results： All operations were successful. Compared with open procedure,laparoscopic procedure was associated with shorter operative time [（ 40. 3 ± 2. 8） min vs.（ 56. 4 ± 3. 2） min,P〈0. 05],less blood loss [（ 12. 3 ± 5. 6） ml vs.（ 25. 6 ± 7. 8） ml,P〈0. 05],less pain [（ 1. 9 ± 0. 6） vs.（ 4. 4 ± 1. 5）,P〈0. 05 ],earlier ambulation [（ 10. 4 ± 1. 6） h vs.（ 15. 3 ± 2. 7） h,P〈0. 05],shorter time to flatus [（ 15. 4 ± 2. 1） h vs.（ 21. 3 ± 3. 8） h,P〈0. 05] and shorter postoperative hospital stay [（ 6 ± 1） d vs.（ 8 ± 2） d,P〈0. 05]. No significant difference was found about complications（ 9. 76% vs. 26. 32%,P〉0. 05）. Conclusions： Laparoscopic procedure for gastric duodenal ulcer perforation has better clinical outcomes in terms of less operative time,blood loss,pain,earlier ambulation,shorter time to flatus and hospital stay. For the patients who has to be converted to laparotomy,surgeons can decide the location of incision with the guidance of laparoscopy,operations can be completed with smaller incision. This procedure is worthy of promotion.
出处
《腹腔镜外科杂志》
2015年第10期785-787,共3页
Journal of Laparoscopic Surgery
