腹腔镜治疗老年胃十二指肠穿孔的临床疗效及安全性观察

Clinical efficacy and safety of laparoscopy in the treatment of elderly patients with gastric and duodenal perforation

目的探讨腹腔镜治疗老年胃十二指肠穿孔的临床疗效及安全性。方法根据手术治疗方式不同将92例老年胃十二指肠穿孔患者分为实验组(52例)和对照组(40例),分别行腹腔镜穿孔修补术和开腹穿孔修补术,比较两组临床疗效及安全性。结果实验组患者平均手术时间、术后排气时间、胃肠功能恢复时间和住院时间均短于对照组,术中出血量少于对照组,术后并发症发生率(5.8%)低于对照组(20.0%),差异有统计学意义(P<0.05);两组术后疗效比较差异无统计学意义(P>0.05)。结论腹腔镜手术治疗老年胃十二指肠穿孔微创优势明显,可促进患者术后尽快恢复,且安全性较高,推荐作为临床治疗该类病症的首选术式。

Objective To analyze the clinical efficacy and safety of laparoscopy in the treatment of elderly patients with gastric and duodenal perforation. Methods A total of 92 elderly patients with gastric and duodenal perforation were divided into experimental group （n=52） who accepted the laparoscopy, and control group （n=40） who accepted the open surgery. The clinical efficacy and safety between the two groups were compared after surgery. Results The surgery duration, the postoperative exhaust time, the time of functional recovery of gastrointestinal tract and the hospitalization time in experimental group were shorter than those in control group, The amount of bleeding during surgery in the, experimental group was less than that in the control group. The incidence rate of complication in experimental group（5.8%） was significant lower than that in control group （20.0%） （P〈0.05）. There was no significant difference between the two group on the efficacy after operation（P〉0.05）. Conclusion The laparoscopy in the treatment of elderly patients with gastric and duodenal perforation has more advantages. The restore time after the laparoscopy is shorter than the traditional procedure. It should be recommended as the first choice in the treatment of gastric and duodenal perforation.