腹腔镜与开腹对胃十二指肠溃疡急性穿孔治疗的临床疗效分析

目的探讨腹腔镜与开腹手术治疗胃十二指肠溃疡急性穿孔的疗效。方法将2015年1月至2016年9月我院收治的80例胃十二指肠溃疡急性穿孔患者作为研究对象进行前瞻性研究。根据随机数字法分为腹腔镜组和开腹组,各40例患者,开腹组采取传统的开腹手术修补穿孔治疗,腹腔镜组采取腹腔镜手术修补穿孔治疗,应用SPSS 22.0统计学软件进行统计学处理,术中及术后相关指标以均数±标准差(x珋±s)表示,组间比较采用独立t检验;术后并发症的发生率及复发率采用卡方(χ2)检验,以P0.05表示差异具有统计学意义。结果与开腹组相比,腹腔镜组的手术时间、切口长度、术后下床活动时间、肛门排气时间和住院时间均显著缩短,术中出血量显著降低,差异具有统计学意义(P0.05);腹腔镜组术后并发症的发生率和复发率分别为5例(12.5%)和1例(2.5%),开腹组分别为13例(32.5%)和6例(15.0%),差异具有统计学意义(P0.05)。结论腹腔镜手术治疗胃十二指肠溃疡急性穿孔患者具有损伤小、手术时间短、恢复快、安全性高等特点,临床上应大力推广应用。

Clinical effect of laparoscopic surgery and laparotomy for acute perforation of gastroduodenal ulcer

Objective To investigate the clinical effect of laparoscopic surgery and laparotomy for acute perforation of gastroduodenal ulcer.Methods From January 2015 to September 2016, 80 patients with acute perforation of gastroduodenal ulcer in our hospital were involved in a prospective study.According to the random number method, the patients were divided into laparoscopic group and open group, 40 cases in each group.The patients of the open group were treated by traditional open surgery, while the patients of the laparoscopic group were treated by laparoscopic perforation repair surgery.Statistical analysis were performed by using SPSS 22.0 software, intraoperative and postoperative relevant indexes were presented as (±s) and examined by using t test;the incidence of complication and recurrence rate after operation were presented as n (%)] and examined by chi square test.The difference was statistically significant by P<0.05.Results Compared with the open group, the operation time, length of incision, postoperative activity out of bed days, anus exhaust time and hospitalization time were significantly shortened, the blood loss of the operation in the laparoscopic group was significantly decreased, the difference was statistically significant (P<0.05);The incidence of complications and recurrence rate after operation of laparoscopic group were 5 cases (12.5%) and 1 cases (2.5%) respectively, while the open group were 13 cases (32.5%) and 6 cases (15.0%) respectively, the difference was statistically significant (P<0.05).Conclusion Laparoscopic treatment for acute perforation of gastroduodenal ulcer has the advantages of less damage, shorter operation time, quicker recovery and higher safety, so it should be widely applied in clinic.