腹腔镜十二指肠球部溃疡穿孔修补术及开腹手术疗效比较.docVIP

腹腔镜十二指肠球部溃疡穿孔修补术及开腹手术疗效比较[摘要] 目的 对比腹腔镜十二指肠球部溃疡穿孔修补术与开腹手术治疗十二指肠球部溃疡穿孔的手术效果，进一步探讨对胃肠功能恢复情况的影响。方法 60例患者随机分为腹腔镜组和开腹组各30例，比较两组手术观察指标及术后胃肠功能恢复情况及并发症发生率。结果 开腹组的手术时间短于腹腔镜组，但腹腔镜组术后下床活动早，住院时间短。术后腹腔镜组的肠鸣音恢复时间、肛门排气、排便时间短于开腹组，并发症发生率（3.33%）低于开腹组（16.67%）（P＜0.05或P＜0.01）。结论腹腔镜下十二指肠球部溃疡穿孔修补术损伤小、痛苦轻、腹腔干扰小、胃肠功能恢复快、术后并发症少。 [关键词] 十二指肠球部溃疡穿孔修补术；开腹；腹腔镜 [中图分类号] R656.6[文献标识码] B[文章编号] 1673-9701（2011）27-47-02 Comparison on the Efficacy of Laparoscopic Duodenal Ulcer Perforation Repair and Open Surgery CHEN Chaohui1CAI Liuxin2 1.Zhejiang Province Taizhou City Huangyan District Red Cross Hospital，Taizhou 318020，China；2.Zhejiang Province Taizhou Hospital，Taizhou 317000，China [Abstract] Objective To compare the effect of laparoscopic duodenal ulcer perforation repair and open surgery of duodenal ulcer effect of surgery，and further explore the impact of recovery of gastrointestinal function. Methods All 60 patients were randomly divided into the laparoscopic group and the laparotomy group，30 cases in each group.We compared surgery observed indicators and the recovery of gastrointestinal function and incidence of complications in two groups. Results The operation time of the laparotomy group was shorter than the laparoscopic group，but get out of bed in laparoscopic group was early，shorter hospital stay. Recovery time of bowel sounds，flatus time，defecation time in the laparoscopic group were shorter，the complication rate（3.33%） was lower than that in the laparotomy group（16.67%）（P＜0.05 or P＜0.01）. Conclusion Laparoscopic duodenal ulcer perforation repair damage，less pain，abdominal disturbance is small，fast recovery of gastrointestinal function，less postoperative complications. [Key words] Duodenal ulcer perforation repair；Laparotomy；Laparoscopic 文献报道，腹腔镜操作能减少对腹腔脏器各方面的刺激，有利于患者术后胃肠动力的恢复[1]。本研究旨在探讨腹腔镜十二指肠球部溃疡穿孔修补术对胃肠功能恢复的影响，现报道如下。 1资料与方法 1.1一般资料 选取2008年2月～2011年2月我院行十二指肠球部溃疡穿孔修补术患者60例，其中男23例，女37例；年龄18～78岁，平均（43.9±4.7）岁；全部患者入院时均有不同程度的板状腹、压痛、反跳痛等临床表现，立位腹部平片示膈下游离气体。按手术方法的选择情