腹腔镜手术在老年胃溃疡穿孔治疗中的临床价值研究

Clinical Value of Laparoscopic Surgery in Perforation of Senile Gastric Ulcer

目的探讨腹腔镜手术在老年胃溃疡穿孔治疗中的临床价值研究。方法方便选取2014年7月—2017年7月在该院外科治疗的60例老年胃溃疡穿孔患者,随机分为两组,对照组30例采用开腹手术治疗,观察组30例采用腹腔镜手术治疗,比较两组患者的各项手术指标、术后疼痛情况及胃内激素水平、并发症发生率。结果观察组手术时间(78.6±6.2)min、术中出血量(30.4±5.2)mL、术后肠鸣音恢复时间(4.3±1.1)h、排气时间(23.8±4.1)h、住院时间(5.6±0.4)d与对照组的(98.3±8.5)min、(73.5±6.8)mL、(7.4±2.3)h、(35.2±5.6)h、(8.2±0.7)d相比差异有统计学意义(P<0.05);观察组术后3 d VAS疼痛评分(2.04±0.47)分、GAS(66.54±14.32)ng/L与对照组的(3.69±0.56)分、GAS(55.71±9.87)ng/L相比差异有统计学意义(P<0.05);观察组术后切口感染、腹腔感染、胃出血、肠梗阻等并发症发生率为3.33%明显低于对照组的16.7%,差异有统计学意义(P<0.05)。结论腹腔镜手术在老年胃溃疡穿孔治疗中的临床价值显著,创伤小,疼痛轻,利于胃功能的恢复,且并发症发生率低,具有积极的临床意义。

Objective This paper tries to investigate the clinical value of laparoscopic surgery in the treatment of gastric ulcer perforation in the elderly.Methods Convenient selection 60 elderly patients with gastric ulcer perforation who underwent surgery in this hospital from July 2014 to July,2017 were randomly divided into two groups.30 patients in the control group were treated by laparotomy.30 patients in the observation group were treated by laparoscopic surgery.In the two groups the various surgical indicators,postoperative pain and hormone levels in the stomach,and the incidence of complications of the patients were compared.Results The operation time of the observation group(78.6±6.2)min,the amount of bleeding(30.4±5.2)mL,postoperative recovery time of bowel sounds(4.3±1.1)h,exhaust time(23.8±4.1)h,hospitalization time(5.6±0.4)d comparared with that in the control group(98.3±8.5)min.(73.5±6.8)mL,(7.4±2.3)h,(35.2±5.6)h,(8.2±0.7)d were significantly different(P<0.05);The 3dVAS pain score in the observation group was(2.04±0.47)points,with GAS(66.54±14.32)ng/L was significantly higher than that in the control group(3.69±0.56)points,and there was a significant difference between GAS(55.71±9.87)ng/L(P<0.05).The rate of incidence of postoperative wound infection,abdominal infection,gastric bleeding and intestinal obstruction in observation group was 3.33%,which was significantly lower than 16.7%in the control group(P<0.05).Conclusion Laparoscopic surgery in the treatment of gastric ulcer perforation in elderly patients has significant clinical value,with small trauma andless pain,and it is conducive to the recovery of gastric function and the incidence of complications is low with a positive clinical significance.