腹腔镜治疗胃十二指肠穿孔的临床研究

目的对比腹腔镜下微创手术与开腹手术治疗胃十二指肠穿孔的临床疗效和安全性。方法选取我院收治的胃十二指肠穿孔患者64例,根据手术治疗方案不同,分为腹腔镜组和开腹组各32例。腹腔镜组采用腹腔镜下胃十二指肠修补术治疗,开腹组采用开腹单纯胃十二指肠修补术治疗,对比两组患者的手术指标及术后并发症。结果两组手术平均时间无差异（P〉0.05）,腹腔镜组术中出血量、术后首次肛门排气时间以及术后住院天数均明显少于开腹组（P〈0.05）,腹腔镜组术后有2例患者需要镇痛,明显少于开腹组的17例（P〈0.05）。腹腔镜组术后并发症发生率9.38%,明显低于开腹组的28.13%（P〈0.05）。结论腹腔镜下胃十二指肠修补术治疗胃十二指肠穿孔具有手术创伤小、患者恢复快、术后疼痛轻以及术后并发症少等优势。

Clinical study of laparoscope in the treatment of gastric and duodenal perforation

Objective To compare the clinical efficacy and safety of minimally invasive laparoscopic operation and laparotomy in the treatment of gastric and duodenal perforation. Methods 64 patients with gastric and duodenal perforation were selected in our hospital. According to the different treatment method, they were divided into laparoscopic group and laparotomy group with 32 patients in each group. The patients in the laparoscopic group underwent laparoscopic gastroduodenal neoplasty, while the patients in the laparotomy group were treated with simple open gastroduodenal neoplasty, the operation index and postoperative complications of both groups were compared. Results The average time of both groups showed no significant difference （P＆gt;0.05）; the amount of bleeding, the exhaust time and postoperative hospital stay of the laparoscopic group were significantly less than that of the control group （P＆lt;0.05）; 2 patients required analgesia in the laparoscopy group, it was significantly lower than the 17 cases of control group （P＆lt;0.05）. The incidence of postoperative complications in laparoscopic group was 9.38%, significantly lower than that of the control group （28.13%）,P＆lt;0.05. Conclusion Laparoscopic gastroduodenal neoplasty in the treatment of gastric and duodenal perforation has the advantages of small operation wound , fast recovery, less postoperative pain and postoperative complications.