基层医院腹腔镜下胃十二指肠穿孔修补术的临床疗效研究

Clinical study of primary hospital laparoscopic gastroduodenal perforation repair

目的 :探讨腹腔镜手术在基层医院胃十二指肠穿孔修补术中临床应用效果。方法 :选择2008年6月至2014年2月我院收治的胃十二指肠穿孔修补术患者90例,其中对照组47例应用传统开腹手术进行治疗,观察组43例应用腹腔镜下胃十二指肠穿孔修补术治疗,比较两组患者手术时间、切口平均长度、术后肠蠕动恢复时间、术后镇痛剂应用次数、术后肠粘连肠梗阻的发生情况、伤口并发症的发生情况手术时间及住院时间。结果 :两组患者均完成胃十二指肠穿孔修补,无死亡病例,腹腔镜组无中转开腹病例。两组患者手术时间差异无统计学意义;观察组切口平均长度显著短于对照组,术后肠蠕动恢复时间及住院时间显著短于对照组,术后镇痛剂应用次数显著少于对照组,术后肠粘连肠梗阻的发生率及伤口并发症的发生率显著少于对照组,两组差异有统计学意义。结论:腹腔镜下胃十二指肠溃疡穿孔修补术是种更加有效安全、创伤性小、疤痕小,恢复快、并发症少的手术方式,值得基层医院临床推广。

Objective To evaluate effect of laparoscopic operation in primary hospital gastric and duodenum perforation repair. Methods 90 cases of patients withrepair of perforation selected from 2008 June to 2014 February in our hospital were chosed, control group(47 cases) used traditional open operation for treatment, observation group(43 cases) used laparoscopic gastroduodenal perforation repair treatment, compared two groups of patients with the average length of incision, postoperative intestinalperistalsis recovery time, postoperative analgesia agentapplication number, postoperative intestinal adhesionintestinal obstruction occurred wound complications,operation time and hospitalization time. Results the two groups of patients completed the gastric and duodenum perforation, no deaths, no case was converted to laparotomy in laparoscopic group. It had no statistically significant differences between two groups of patients with operation time; average length of incision in observation group was significantly shorter than that in control group, postoperative intestinal peristalsis recovery time was significantly shorter than that in control group, postoperative analgesic frequency significantly less than the control group, postoperative adhesive intestinal obstruction and the incidence of wound complicationsoccurred significantly less than the control group, there wassignificant difference between two groups. Conclusion laparoscopicgastric ulcer perforation repair is a more effective, safety, traumatic small, small scar, operation mode, less complications and quick recovery, it is worthy of clinicalpopularization of basic level hospital.