不同手术方式对胃十二指肠溃疡急性穿孔的疗效研究

The curative effects of different operation modes on acute perforation of gastroduodenal ulcer

目的研究不同手术方式治疗胃十二指肠溃疡急性穿孔的疗效。方法选取2019年2~12月诊治的胃十二指肠溃疡急性穿孔患者102例,均行手术治疗,根据不同术式分为A组与B组,每组51例。A组行开腹手术,B组行腹腔镜手术,比较2组疗效、临床指标(手术时间、出血量、肛门排气时间、胃肠功能恢复时间、下床活动时间、住院时间)、胃蛋白酶(胃蛋白酶原Ⅰ、胃蛋白酶原Ⅱ)及并发症(切口感染、肺部感染、腹腔脓肿、黏连性梗阻)。结果B组总有效率(94.1%)高于A组(80.4%)(P<0.05);B组临床指标优于A组(P<0.05);B组术后胃蛋白酶水平高于A组,差异有统计学意义(P<0.05);B组并发症发生率(3.9%)低于A组(17.6%),差异有统计学意义(P<0.05)。结论不同手术治疗胃十二指肠溃疡急性穿孔的疗效存在一定的差异性,腹腔镜手术为微创术式,与开腹手术相比具有手术时间短、出血量少、住院时间短、恢复快等优势,且能促进胃蛋白酶恢复,值得临床应用。

Objective To investigate the curative effects of different operation modes on acute perforation of gastroduodenal ulcer.Methods A total of 102 patients with acute perforation of gastroduodenal ulcer who were treated in our hospital from February 2019 to December 2019 were divided into group A and group B,with 51 cases in each group.The patients in group A were treated by laparotomy,however,those in group B were treated by laparoscopy.The curative effects and clinical indexes(operation time,bleeding volume,anal exhaust time,gastrointestinal function recovery time,time of getting out of bed,hospital stays),the expressions of pepsase(pepsinogenⅠ,pepsinogenⅡ)and the complications(incision infection,lung infection,abdominal abscess,adhesive obstruction)were observed and compared between the two groups.Results The total effective rate in group B was significantly higher than that of group A(94.1%vs 80.4%,P<0.05).Moreover the clinical indexes in group B were superior to those in group A(P<0.05).The postoperative pepsin levels in group B was significantly higher than those in group A(P<0.05).In addition the incidence rate of complication rates in group B was significantly lower than that in group A(3.9%vs 17.6%,P<0.05).Conclusion As compared with laparotomy,the laparoscopic surgery is a minimally invasive operation,which has the advantages of shorter operation time,less bleeding,shorter hospitalization time and faster recovery,which can promote the recovery of pepsin,therefore,which is worth clinical application.