腹腔镜与开放手术治疗腹膜内型膀胱破裂的疗效比较

目的：比较腹腔镜与开放手术治疗腹膜内型膀胱破裂的疗效。方法50例腹膜内型膀胱破裂患者，26例行腹腔镜膀胱破裂修补术，24例行开放膀胱破裂修补术。比较两组手术时间、术中出血量、肠道恢复时间、住院时间、止痛药的使用率及并发症的发生率。结果两组手术均顺利完成，腹腔镜组与开放组手术时间分别为（55．12±8．53）min 和（64．48±13．21）min，差异有统计学意义（P ＞0．05）；术中出血量分别为（54．24±5．38）ml 和（89．35±12．17）ml，P ＜0．05；肠道功能恢复时间分别为（23．24±2．39）h 和（38．42±6．98）h，差异有统计学意义（P ＜0．05）；住院时间分别为（4．64±1．42）d 和（7．04±1．29）d，差异有统计学意义（P ＜0．05）；止痛药的使用率分别为38．46％（10／26）和75．00％（18／24），差异有统计学意义（P ＜0．05）；术后并发症发生率分别为7．69％（2／26）和8．33％（2／24），差异无统计学意义（P ＞0．05）。结论与开放术式比较，腹腔镜治疗腹膜内型膀胱破裂具有创伤小、恢复快等优点。

Treatment of intraperitoneal bladder rupture:a comparative study between laparoscopic and open surgery

Objective To compare the clinical efficacy of laparoscopic surgery and open surgery for intraperitoneal bladder rupture.Methods From January 2004 to August 2013,the clinical data and therapeutic methods of 50 patients with intraperitoneal bladder rupture were retrospectively reviewed,inclu-ding 26 cases of laparoscopic surgery and 24 cases of open surgery.The operative time,intraoperative blood loss,postoperative intestinal recovery,hospital stay,analgesic use rate and complication ratio were com-pared between the two groups.Results All surgeries were successfully performed.There were significant differences in intraoperative blood loss （54.24 ±5.38）ml vs（89.35 ±12.17）ml],intestinal recovery time （23.24 ±2.39）h vs（38.42 ±6.98）h],hospital stay （4.64 ±1.42）d vs（7.04 ±1.29）d]and analgesic use rate 38.64%（10 /26）vs 75.00%（18 /24）]between laparoscopy group and open surgery group,respectively（P 0.05）.Conclusion Laparoscopic treatment of intraperitoneal bladder rupture has the advantages of mini-invasion and rapid re-covery compared with traditional open surgery.