腹腔镜下修补术治疗十二指肠溃疡急性穿孔的临床疗效与安全性分析

Clinical analysisofcurative effect and safety of laparoscopicrepair in treating acute perforation of duodenal ulcer

目的分析腹腔镜下修补术治疗十二指肠溃疡急性穿孔的临床疗效与安全性。方法回顾性分析2013年6月至2015年6月行十二指肠溃疡急性穿孔修补术的124例患者临床资料,根据手术方法不同分为腹腔镜组(腹腔镜下进行穿孔修补手术,62例)和开腹组(传统开腹穿孔修复手术,62例),采用SPSS 17.0软件进行分析,围术期各种指标及住院时间等计量资料采用平均值±标准差表示,进行t检验;术后体温高于38℃例数、胃肠道不良反应、术后疼痛程度情况以及术后并发症发生情况等计数资料采用例数或率表示,进行χ~2检验;P<0.05差异有统计学意义。结果腹腔镜组患者的手术时间、术后首次下床活动时间、首次排气时间及平均住院时间均短于开腹组(P<0.05);腹腔镜组术中出血量为(7.7±1.1)ml,明显少于开腹组(P<0.05);术后体温高于38℃例数、胃肠道不良反应发生情况和并发症的发生率、术后第1天和第3天疼痛降低程度均明显优于开腹组(P<0.05);术后12个月,腹腔镜组复发率为9.7%明显低于开腹组25.8%,以上差异均有统计学意义(P<0.05)。结论腹腔镜下修补术治疗十二指肠溃疡急性穿孔具有安全性好、疗效好、并发症少、恢复快等优点,值得广泛推广和应用。

Objective To analyze the curative effect and safetyof laparoscopic repair in treating acute perforation of duodenal ulcer. Methods From June 2013 to June 2015, clinicaldata of 124 patients with acute perforationof duodenal ulcer, underwent laparoscopicduodenal ulcer repair, were analyzed retrospectively. 62 patients were divided into laparoscopic group, while 62 patientsinto laparotomy group. Statistical analysis wereperformed by using SPSS 17. 0 software. The measurement data such asperioperativeindicators and hospitalization staywere expressed x± s, andwere examined by using t test. Count data suchaspatients with hyperpyrexia 〉 38℃ , complication rate, pain score and ulcer relapsed ratewere examined by using χ2 test, A P value 〈 0. 05 was considered as statistically significantdifference. Results The operationtime, postoperative ambulation time, exhaust time and average time of hospitalstay were significantly shorter inlaparoscopicgroup thanthose in laparotomy group （P 〈 0. 05 ）. Blood loss oflaparoseopic group of （7.7 ± 1.1 ） ml was significantly less than that inlaparotomy group （ P 〈 0.05 ）. Patients with hyperpyrexia 〉 38℃, gastrointestinal side reaction and complication rate were significantly less in laparoscopic group than those in laparotomy group （P 〈0.05 ）. 12 months after surgery, in laparoscopic group the recurrence rate of 9.7% was significantly lower than 25.8% in laparotomy group （ P 〈 0.05 ）. Conclusion Laparoscopicduodenalulcerrepair has advantages of safety, reliability, better curativeeffect, less complications and quicker recovery, which is worth of clinicalpromotion.