腹腔镜与开放手术治疗胃十二指肠溃疡急性穿孔的疗效比较

Comparison of the Efficacy of Laparoscopic and Open Surgery in the Treatment of Acute Perforation of Gastroduodenal Ulcer

目的探讨对于胃十二指肠溃疡急性穿孔的患者分别采取腹腔镜辅助与开放手术治疗的临床效果。方法回顾性选取2021年1月—2023年9月东海县人民医院接受手术治疗的55例胃十二指肠溃疡急性穿孔患者的临床资料,根据不同手术方式进行分组,其中治疗组27例接受腹腔镜手术,对照组28例采用开放手术。比较两组术中、术后评价指标及并发症。结果两组手术时长比较,差异无统计学意义(P>0.05);治疗组切口长度(2.66±0.28)cm短于对照组,术中出血量(26.66±7.14)mL少于对照组,差异有统计学意义(t=19.212,11.601,P均<0.05)。治疗组的术后疼痛评分、首次肛门排气时间、离床活动时间、术后住院天数均优于对照组,差异有统计学意义(P均<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论以腹腔镜辅助下治疗胃十二指肠溃疡急性穿孔,其疗效肯定,和开放性手术进行比较,前者对患者的损伤更小,且恢复快,安全性高。

Objective To investigate the clinical effect of laparoscopic and open surgery for acute perforation of gastroduodenal ulcer.Methods Clinical data of 55 patients with acute gastroduodenal ulcer perforation who received surgical treatment in Donghai County People's Hospital from January 2021 to September 2023 were retrospectively selected,and grouped according to different surgical methods.27 patients in the treatment group received laparoscopic surgery,and 28 patients in the control group received open surgery.The intraoperative and postoperative evaluation indexes and complications were compared between the two groups.Results There was no significant difference in operation duration between the two groups(P>0.05).Incision length(2.66±0.28)cm in the treatment group was shorter than that of the control group,and intraoperative blood loss(26.66±7.14)mL was less than that in the control group,and the differences were statistically significant(t=19.212,11.601,both P<0.05).Postoperative pain score,first anal exhaust time,out of bed activity time,postoperative hospitalization days were better in the treatment group than in the control group,and the differences were statistically significant(all P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Laparoscopic-assisted treatment of acute perforation of gastroduodenal ulcer has a positive effect.Compared with open surgery,the former has less damage to patients,faster recovery and higher safety.