腹腔镜下胃十二指肠溃疡穿孔修补术对患者胃肠功能的影响

Influence of laparoscopic repair of gastroduodenal ulcer perforation on gastrointestinal function of patients

目的比较研究腹腔镜与开腹手术应用于胃十二指肠溃疡穿孔治疗中的价值,探讨腹腔镜下胃十二指肠溃疡穿孔修补术对患者胃肠功能的影响。方法选取该院2012年1月‐2014年12月胃十二指肠溃疡穿孔患者116例为研究对象,采用随机数字表法将其分为腔镜组(腹腔镜下穿孔修补)和开腹组(开腹穿孔修补),比较两组患者手术一般情况和并发症发生情况。结果腔镜组4例中转开腹,其余54例均顺利完成镜下修补;腔镜组患者手术时间、肠蠕动恢复时间和住院时间分别为(61.47±5.73)min、(28.03±7.49)h和(6.59±1.48)d,均短于开腹组患者的(68.21±5.41)min、(61.52±12.37)h和(10.16±2.65)d(P<0.05);腔镜组患者术后镇痛剂使用率为6.90%(4/58),低于开腹组患者的46.55%(27/58)(P<0.05);腔镜组术后并发症发生率为1.72%(1/58),明显低于开腹组患者的13.79%(8/58)(P<0.05)。结论腹腔镜下胃十二指肠溃疡穿孔修补术有助于促进减少术后并发症,促进患者术后恢复。

[Objective]To compare and study the value of laparoscopy and open surgery in the treatment of gastroduodenal ulcer perforation,and to probe into the influence of laparoscopic repair of gastroduodenal ulcer perforation on patients＇ gastrointestinal function.[Methods]A total of 116 patients with gastroduodenal ulcer perforation in our hospital from January2012 to December 2014 were selected as the research objects,and were randomly divided into the laparoscopic group（laparoscopic perforation repair） and laparotomy group（laparotomy perforation） by the random number table method.Then,the general situation and complications of the two groups of patients were compared.[Results]In laparoscopic group,4 cases were converted to laparotomy,the other 54 cases were successfully completed endoscopic repair;the operation time,recovery time of intestinal peristalsis and hospitalization time of patients in the laparoscopic group were（61.47±5.73） min,（28.03±7.49） h and（6.59 ±1.48） d,which were shorter than（68.21±5.41） min,（61.52±12.37） h and（10.16± 2.65） d of the patients in the laparotomy group（P〈0.05）;the analgesic use rate after operation of patients in the laparoscopic group was 6.90%（4/58）,which was lower than 46.55%（27/58）in the laparotomy group（P〈0.05）;the complication rate of patients in the laparoscopic group was 1.72%（1/58）,which was significantly lower than 13.59%（8/58） in the laparotomy group（P〈0.05）.[Conclusion]The laparoscopic repair of gastroduodenal ulcer perforation can help to reduce postoperative complications and promote postoperative recovery.