腹腔镜手术与开腹手术在治疗胃十二指肠溃疡穿孔对比研究.docVIP

腹腔镜手术与开腹手术在治疗胃十二指肠溃疡穿孔对比研究 　　摘要：目的：对比分析腹腔镜手术与开腹手术在治疗胃十二指肠溃疡穿孔中的临床效果。方法：回顾d性分析2011年6月至2014年6月笔者所在医院收治、纳入本研究的63例胃十二指肠穿孔患者临床资料，根据患者手术方式分为腹腔镜组（31 例）及开腹组（32 例），对比两组患者临床资料及围手术期的相关临床指标。 结果： 两组手术时间、住院费用、2个月后溃疡愈合率之间相比差异均无统计学意义（P 0.05）；腹腔镜组术后疼痛明显较轻（P 0.05）；全身炎症反应综合征（SIRS）症状改善时间、下床活动时间、肛门排气时间、进食时间及术后出院时间均早于开腹组（P 0.05）；腹腔镜组术中出血量、术后并发症发生率少于开腹手术组（P 0.05），差异有统计学意义。结论：胃十二指肠溃疡穿孔行腹腔镜修补术具有患者创伤小、康复快、并发症少等优点，值得推广应用。 　　关键词：胃十二指肠溃疡穿孔；腹腔镜；开腹手术 　　Abstract：Objective To compare the clinical effect of laparoscopy and laparotomy in the treatment of perforated gastroduodenal ulcer. Methods The clinical data of 63 patients with perforated gastroduodenal ulcer from June 2011 to June 2014 were retrospectively analyzed and included in this study. According to the different treatment method they were divided into Iaparoscopic group with 31 patients and Iaparotomy group with 32 patients. The clinical data and the perioperative clinical parameters were compared. Results There were no significant difference between the 2 groups in the operation time， the hospitalization expense and the peptic ulcer concrete rate （ P 0.05）. The level of pain after operation in observation group was significantly less compared with control group （ P0.05）. Laparoscopic operation group is superior to traditional operation group in improvement time of SIRS symptoms， off-bed time， exhaust time， first time of eating， and hospital stay（ P 0.05）. The blood loss and the total incidence rate of postoperative complications in observation group were significantly decreased compared with control group （P 0.05）. Conclusions Laparoscopic operation for the repair of perforated gastroduodenal ulcer has the advantages of small trauma， rapid recovery and few adverse reactions， and it is worthy to be recommended in clinic. 　　Keywords：Peptic ulcer perforation； Laparoscopy； Laparotomy 　　胃十二指肠溃疡穿孔是外科最常见的急腹症之一，早期手术治疗是最为确切有效的治疗手段。随着腹腔镜手术设备的改进及手术技巧的提高，目前采用腹腔镜手术越来越多，具有创伤少、术后恢复快等优点。2011年6月至2014年6月笔者所在医院收治103例胃十二指肠穿孔手术患者，其中63例纳入本研究，根据患者手术方式分为