腹腔镜与开腹手术治疗胃穿孔的临床效果对照研究

A Comparative Study of Clinical Effects of Laparoscopic and Open Surgery for Gastric Perforation

目的观察腹腔镜与开腹手术治疗胃穿孔的临床效果。方法随机选择2012年1月—2018年6月到该院进行胃穿孔手术患者120例进行临床研究。使用随机数字法将患者分为对照组和观察组各60例。所有患者术前给予禁食水、胃肠减压、导尿等常规处置,对照组患者给予开腹手术修补胃穿孔。观察组患者行腹腔镜胃穿孔修补术。对两组相关指标和并发症情况进行比较。结果对照组手术时间为(77.81±6.27)min,明显高于对照组(65.44±7.13)min (t=10.092,P=0.000);观察组术中出血量为(27.44±5.26)mL,明显低于对照组(65.34±10.09)m L(t=25.800,P=0.000),术中冲洗液用量(1 429.55±105.27)mL,明显少于对照组(2 884.71±155.63)m L(t=29.991,P=0.000)。比较术后各项指标和哌替啶用量,观察组优于对照组,分别为(30.34±15.88)、(85.29±19.06)mg(t=17.157,P=0.000)。观察组术后并发症发生率为3.33%,明显低于对照组16.67%(χ2=4.537,P=0.033)。结论对于胃穿孔治疗,腹腔镜手术与开腹手术相比对患者损伤更小,患者术后恢复快,且明显降低了术后并发症的发生率。

Objective To observe the clinical effect of laparoscopic and open surgery for gastric perforation.Methods A total of 120 patients with gastric perforation surgery from January 2012 to June 2018 were randomly selected for clinical study.Patients were divided into control group and observation group by 60 cases using random number method.All patients were given routine treatment such as fasting water,gastrointestinal decompression,catheterization,etc.,and the control group were given open surgery to repair gastric perforation.Patients in the observation group underwent laparoscopic gastric perforation repair.Compare the two groups of related indicators and complications.Results The operation time of the control group was (77.81±6.27)min,which was significantly higher than that of the control group(65.44±7.13)min(t=10.092,P=0.000).The intraoperative blood loss was (27.44±5.26)mL,which was significantly lower than the control group (65.34±10.09) mL(t=25.800,P=0.000),the amount of irrigation fluid during operation(1 429.55±105.27)mL was significantly less than that of the control group (2 884.71±155.63)mL(t=29.991,P=0.000).The postoperative indexes and the amount of meperidine were compared.The observation group was superior to the control group (30.34±15.88)mg and (85.29±19.06)mg (t=17.157,P=0.000).The postoperative complication rate was 3.33% in the observation group,which was significantly lower than 16.67% in the control group (χ^2=4.537,P=0.033).Conclusion For gastric perforation,laparoscopic surgery has less damage to patients than laparotomy.The patient recovers quickly and significantly reduces the incidence of postoperative complications.