腹腔镜下医用生物蛋白胶粘堵治疗上消化道溃疡穿孔18例报告

目的：探讨腹腔镜下医用生物蛋白胶（biomedical fibrin sealant,BFS）粘堵胃、十二指肠球部溃疡穿孔的应用价值。方法：腹腔镜下手术治疗上消化道溃疡穿孔18例。先将明胶海绵填塞入穿孔处,再在其表面和周围浆膜面喷洒医用生物蛋白胶1.5～2.0 mL。结果：18例均痊愈出院。手术时间30～90 min,平均45 min,术后住院4～8 d,平均5.5 d。结论：腹腔镜下应用医用生物蛋白胶粘堵治疗胃、十二指肠球部溃疡穿孔方法,具有疗效可靠,痛苦小、恢复快、并发症少、住院时间短和操作简便等优点,值得推广使用。

Application of Biomedical Fibrin Sealant in 18 Patients with Upper Gastrointestinal Ulcerative Perforation

Objective: To assess advantages of biomedical fibrin sealant(BFS) in the treatment of gastric and duodenal bulb ulcerative perforation with help of laparoscope.Methods: 18 patients with upper gastrointestinal ulcerative pertoratin were treated with help of laparoscope.A spongostan was first rolled into a cone-shaped plug,whose pointed-end toward the perforated hole,so a plug was inserted.Thereafter,1.5-2 mL of BFS was dropwisely added onto and around the spongostan.Results: All the patients were discharged with fully recovery.The operation consuming time ranged from 30 to 90 min,an average of 45 min.The mean hospital stay was of 5.5 days(ranges of 4-8 days).Conclusions:Repairing the gastric and duodenal bulb ulcerative perforation with biomedical fibrin sealant under laparoscopy,showed many advantages,such as solid curative effects,little pain,fast recovery,few complications,shorter hospital stays,convenient and easy manipulation.Therefore,general application of this technique should be recommended clinically.