胃十二指肠溃疡穿孔腹腔镜修补术50例疗效的研究.docVIP

胃十二指肠溃疡穿孔腹腔镜修补术50例疗效的研究 　　[摘要] 目的 观察胃十二指肠溃疡穿孔腹腔镜修补术的疗效。方法 选取100例胃十二指肠溃疡穿孔患者作为观察对象，随机分为观察组和对照组各50例。对照组行常规开腹修补术；观察组行胃十二指肠溃疡穿孔腹腔镜修补术。观察比较两组的手术效果情况。结果 观察组的术中出血量、术后肛门排气时间、住院时间明显短于对照组（P＜0.05或P＜0.01）。观察组发生切口出血、切口感染及肠梗阻的发生例数明显少于对照组。结论 胃十二指肠溃疡穿孔腹腔镜修补术具有良好的疗效，并发症少，适合基层医院广泛推广和应用。 　　[关键词] 胃十二指肠溃疡穿孔；腹腔镜修补术；并发症 　　[中图分类号] R656.6 [文献标识码] B [文章编号] 1673-9701（2011）35-120-02 　　 　　Laparoscopic Repair of Perforated Gastriculcer 50 Cases 　　XU Honggen 　　Department of General Surgery, the First People’s Hospital of Wenling City, Wenling 317500, China 　　 　　[Abstract] Objective To observe the effect of the laparoscopic repair treatment gastriculcer. Methods All of 100 cases patients with gastric ulcer were randomly divided into observation group treated laparoscopic repair of perforated gastric ulcer, and control group treated conventional open surgery repair, each group 50 cases respectively. The effect and complications of surgery cases were observed. Results The blood loss of observation group, postoperative anal exhaust time, hospital stay was significantly shorter than control group (P＜0.05 or P＜0.01). The wound bleeding, wound infection and the incidence of intestinal obstruction in observation group were less than those in control group. Conclusion Laparoscopic repair of perforated gastriculcer has good efficacy and few complications, for basic hospital application widely. 　　[Key words] Gastriculcer perforation; Laparoscopic repair; Complications 　　 　　胃十二指肠溃疡穿孔是上消化道溃疡常见的并发症之一，腹腔镜胃十二指肠溃疡穿孔修补术最早在1989年Mouret等报道，临床上已经广泛应用并已获得确切疗效。本文将腹腔镜胃十二指肠溃疡穿孔修补应用于胃十二指肠溃疡穿孔的治疗，并与常规开腹修补术做比较，现报道如下。 　　1 资料与方法 　　1.1 一般资料 　　选择2009年10月~2011年6月在我院就诊的胃十二指肠溃疡穿孔患者100例作为观察对象，其中男性66例，女性34例，平均年龄（36.7±3.8）岁。按随机表将100例患者随机分为观察组（行腹腔镜手术）和对照组（常规开腹修补术）各50例。两组的性别、年龄、溃疡病史及溃疡穿孔至手术时间等一般资料比较，差异均无统计学意义，具有可比性。 　　1.2 手术方法 　　常规术前准备,对照组仅作常规开腹手术。腹腔镜组患者予全麻，脐下穿刺建立CO2气腹，从左右锁骨中线肋缘下2cm置操作孔，找到穿孔处，取活组织检查，镜下缝合穿孔并用大网膜覆盖穿孔处，结扎或用明胶海绵制成圆锥状塞入穿孔处，冲洗腹腔。两组术后均给予禁食水、胃肠减压、补液、抑酸、抗感染治疗。 　　 　　1.3 观察指标 　　手术时间，术中出血量，术后肛门排气时间，住院时间及术后并发症等。