腹腔镜与开腹穿孔修补术治疗胃十二指肠溃疡急性穿孔患者的效果比较

Comparison of effects of laparoscopic and open perforation repair in treatment of patients with acute perforation of gastroduodenal ulcer

目的:比较腹腔镜与开腹穿孔修补术治疗胃十二指肠溃疡急性穿孔患者的效果。方法:选取92例胃十二指肠溃疡急性穿孔患者作为研究对象,按掷硬币法将其分为对照组和观察组各46例。对照组采用开腹穿孔修补术,观察组采用腹腔镜穿孔修补术,比较两组临床指标水平、术后48 h镇痛剂使用率、术后1周并发症发生率和随访3个月复发率。结果:观察组手术时间、下床活动时间和住院时间短于对照组,术中出血量低于对照组,差异均有统计学意义(P<0.05);观察组镇痛剂使用率为4.35%(2/46),低于对照组的17.39%(8/46),差异有统计学意义(P<0.05);两组术后并发症发生率和复发率比较,差异均无统计学意义(P>0.05)。结论:腹腔镜穿孔修补术治疗胃十二指肠溃疡急性穿孔患者能改善临床指标水平,降低镇痛剂使用率,效果优于开腹穿孔修补术治疗。

Objective:To compare effects of laparoscopic and open perforation repair in treatment of patients with acute perforation of gastroduodenal ulcer.Methods:92 patients with acute perforation of gastroduodenal ulcer were selected as the research objects,and were divided into control group and observation group according to the coin flip method,each with 46 cases.The control group used open perforation repair,while the observation group used laparoscopic perforation repair.The level of clinical indicators,the use of analgesics 48 hours after the operation,the incidence of complications 1 week after the operation,and the recurrence rate at 3-month-follow up were compared between the two groups.Results:The operation time,the out-of-bed activity tine,and the hospital stay in the observation group were shorter than those in the control group;the blood loss during the operation was lower than that in the control group;and the differences were statistically significant(P<0.05).The use rate of analgesics in the observation group was 4.35%(2/46),which was lower than 17.39%(8/46)in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of postoperative complications and recurrence rate between the two groups(P>0.05).Conclusions:Laparoscopic repair of perforation in the treatment of the patients with acute perforation of gastroduodenal ulcer can improve the levels of clinical indicators and reduce the use of analgesics.Moreover,it is superior to open perforation repair.