腹腔镜与开腹手术治疗急性上消化道穿孔33例临床分析

Clinical analysis of 33 cases on acute upper gastrointestinal perforation treated by laparoscopy and laparotomy

目的比较腹腔镜与开腹手术治疗急性上消化道穿孔的疗效。方法回顾性分析我科2021年1月至2021年12月行手术治疗的33例消化道穿孔患者的临床资料,21例经腹腔镜手术治疗(其中1例系腹腔镜+小切口辅助,余20例完全腹腔镜)为腹腔镜组,12例经开腹手术治疗为开腹组。比较2组的手术时间、出血量、肠道功能恢复时间、术后白细胞计数、术后疼痛分级、住院天数及费用的差异。结果腹腔镜组在出血量、肠道功能恢复时间、术后白细胞计数、术后疼痛分级、住院天数及费用与开腹组比较差异有统计学意义(P<0.05)。结论腹腔镜手术治疗急性上消化道穿孔具有创伤小、恢复快、治疗费用低等明显优势。

Objective:To compare the efficacy of laparoscopy and laparotomy in the treatment of acute upper gastrointestinal perforation.Methods:The clinical data of 33 patients with gastrointestinal perforation who underwent surgical treatment in our department from January 2021 to December 2021 were retrospectively analyzed,and 21 patients were treated by laparoscopic surgery(one of them was assisted by laparoscopy+small incision,the other 20 cases of complete laparoscopy)were the laparoscopic group,and 12 cases were treated by laparotomy as the laparotomy group.The differences in operation time,blood loss,bowel function recovery time,postoperative white blood cell count,postoperative pain classification,hospitalization days and costs were compared between the two groups.Results:Compared with the laparotomy group,the laparoscopic group had statistically significant differences in blood loss,bowel function recovery time,postoperative white blood cell count,postoperative pain classification,length of hospital stay and cost(P<0.05).Conclusion:Laparoscopic surgery for acute upper gastrointestinal perforation has obvious advantages such as less trauma,faster recovery and lower treatment cost.