腹腔镜下穿孔修补术治疗中老年十二指肠溃疡合并胃穿孔的疗效

Efficacy of laparoscopic perforation repair for the treatment of middle and old aged patients with duodenal ulcer and gastric perforation

目的探讨腹腔镜下穿孔修补术治疗中老年十二指肠溃疡合并胃穿孔的临床疗效。方法采用数字表法将86例十二指肠溃疡合并胃穿孔中老年患者分为对照组(开腹)和治疗组(腹腔镜),各43例。比较两组治疗效果。结果治疗组下床活动时间、首次排气时间、肠胃功能恢复时间和溃疡疼痛程度评分均显著优于对照组(P<0.05);治疗组在治疗后3、6个月的复发率均低于对照组(P<0.05);治疗组并发症总发生率显著低于对照组(P<0.05);治疗组患者CRP、IL-1β及TNF-α水平均显著低于对照组(P<0.05)。结论中老年十二指肠溃疡合并胃穿孔患者采用腹腔镜下穿孔修补术治疗效果显著,值得临床推广应用。

Objective To explore the clinical efficacy of laparoscopic perforation repair for the treatment of middle andold aged patients with duodenal ulcer and gastric perforation. Methods Eighty -six middle and old aged patients withduodenal ulcer and gastric perforation were divided into control group （open surgery） and treatment group （laparoscopic） bynumber table method, with 43 cases in each group. The treatment effects of the two groups were compared. Results Thetime of get out of bed and first exhaust, gastrointestinal function recovery time and the score of degree of ulcer pain in thetreatment group were significantly better than those in the control group （P〈0.05）. The recurrence rates of the treatmentgroup at three and six months after treatment were significantly lower than those of the control group（P〈0.05）. The totalincidence of complications in the treatment group was significantly lower than that in the control group（P〈0.05）. The levelsof CRP, IL-1β and TNF-α in the treatment group were significantly lower than those in the control group（P〈0.05）.Conclusion Laparoscopic perforation repair for the treatment of middle and old aged patients with duodenal ulcer andgastric perforation is effective and worth clinical application.