双向缝合方法在腹腔镜胃十二指肠穿孔修补术中的应用研究

Application research of bidirectional suture on laparoscopic repair of gastroduodenal perforation

目的探讨双向缝合在腹腔镜胃十二指肠穿孔修补术中的应用及效果。方法总结分析采用双向缝合方法实施的腹腔镜胃十二指肠穿孔修补术22例的临床资料,并与23例常规腹腔镜胃十二指肠穿孔修补术比较,观察比较两组患者的主要手术指标、术后并发症发生情况。结果两组患者均完成手术,两组患者术前一般资料,穿孔病灶直径比较差异均无统计学意义(P>0.05),但双向缝合组在手术缝合时间[(26.05±8.06)min]、手术时间[(94.45±22.95)min]、术中出血量[(49.55±21.93)mL]均优于常规缝合组的手术缝合时间[(39.91±12.82)min]、手术时间[(130.35±38.53)min]、术中出血量[(67.83±33.30)mL],差异有统计学意义(P<0.05)。常规缝合组术中有2例患者中转开腹手术,1例患者术后腹腔残余感染,但两组比较差异无统计学意义(P>0.05)。两组患者均顺利出院,术后随访6个月两组患者均无幽门狭窄、消化道出血等异常并发症。结论腹腔镜下双向缝合方法在临床应用安全有效,效果明显优于传统缝合技术,可明显降低缝合难度。

Objective To explore the application and effect of bidirectional suture in laparoscopic gastroduodenal perforation repair.Methods The clinical data of 22 cases of laparoscopic gastroduodenal perforation repair with bidirectional suture were summarized and analyzed,which was compared with the clinical data of 23 cases of conventional laparoscopic gastroduodenal perforation repair.The major surgical indicators and occurrence of postoperative complications were observed and compared.Results Both groups completed surgery.There were no significant differences in general information and the diameters of perforation sites(P>0.05).In the bidirectional suture group,the operation suture time[(26.05±8.06)min],operation time[(94.45±22.95)min],intraoperative blood loss[(49.55±21.93)mL]all were better than the operation suture time[(39.91±12.82)min],operation time[(130.35±38.53)min],intraoperative blood loss[(67.83±33.30)mL]in the conventional suture group.The differences were statistically significant(P<0.05).In the conventional suture group,2 cases were transferred to laparotomy,and 1 case was complicated with residual abdominal infection.However,the difference was not statistically significant(P>0.05).Both groups were discharged smoothly.No abnormal manifestations such as pyloric stenosis and gastrointestinal bleeding were found in the two groups after 6 months of following-up.Conclusion The clinical application of laparoscopic bidirectional suture technology is safe and effective,its effect is obviously better than that of conventional suture technology,and can sgnificantly reduce the difficulty of suture.