腹腔镜与开腹手术治疗胃十二指肠溃疡穿孔临床疗效对比

Clinical efficacy of laparoscopic versus open repair operation for perforated peptic ulcer

目的比较腹腔镜下胃十二指肠溃疡穿孔修补术与开腹修补术的临床疗效。方法回顾性分析2013年1月至2017年1月在本院行胃十二指肠溃疡穿孔修补术的100例患者的临床资料,其中腹腔镜修补术和开腹修补术各50例,比较两组手术效果和术后并发症发生情况。结果腹腔镜组对比开腹组的手术时间略有延长(P<0.001)。腹腔镜组在术中出血量、术后肛门排气时间、术后住院时间、术后疼痛评分、住院费用均少于开腹组(均P<0.001)。腹腔镜组总的并发症发生率低于开腹组(P<0.001);尤其在预防术后切口感染具有良好的优势(P=0.031)。结论腹腔镜下胃十二指肠溃疡穿孔修补术对比传统开腹手术具有创伤少,疼痛轻,并发症少,术后恢复快的优点,值得临床推广。

Objective To compare the clinical efficacy of laparoscopic and traditional open repair operation for perforated peptic ulcer. Methods From January 2013 to January 2017, the clinical data of one hundred patients with perforated peptic ulcer underwent laparoscopic or traditional open repair operation was analyzed prospectively. Among them, laparoscopic group and open group included fifty cases respectively. The efficacy of operation and incidence of postoperative complications were compared between two groups. Results The average operative time in laparoscopic group was longer than the open group （P〈0.001）. The intraoperative blood loss, anal exhaust time, the length of hospital stay, postoperative pain score and hospital- ization expenses in laparoscopic group were lower than that of the control group. The incidence of postopera- tive complications in laparoscopic group was lower than that of the control group （P〈0.O01）. Especially, it has a good advantage in preventing postoperative wound infection （P=0.03l）. Conclusion Compared with traditional open operation, laparoscopic repair of gastroduodenal ulcer perforation has the advantages of less trauma, less pain, less complications and faster postoperative recovery. It is worthy of clinical promotion.