腹腔镜下修补手术治疗上消化道穿孔疗效观察

目的探讨观察腹腔镜下修补手术治疗上消化道穿孔的临床疗效。方法选择2009年6月至2011年6月期间我院普外科收治的72例上消化道穿孔患者,随机平均分为两组,研究组（36例）采用腹腔镜下修补手术治疗,对照组（36例）采用直接开腹修补手术治疗,观察对比两组患者术中和术后情况。结果研究组手术所需时间、切口长度、术中出血量、术中寻找病灶时间均明显优于对照组,差异均有统计学意义（P〈0.05）。研究组术后疼痛评分、肛门排气时间、下床和住院时间均明显优于对照组,差异均有统计学意义（P〈0.05）;研究组术后并发症发生率为0.0%,显著低于对照组的11.1%,差异有统计学意义（P〈0.05）。结论腹腔镜下修补手术在治疗上消化道穿孔方面临床疗效确切,安全性高,创伤小,恢复快,值得临床推广和普及。

Clinical Observation of Laparoscopic Repair in the Treatment of Upper Digestive Tract Perforation

Objective To explore the clinical effect of laparoscopic repair in the treatment of upper digestive tract perforation.Methods 72 cases of upper digestive tract perforation were collected and randomly divided into two groups（research group and control group）,with 36 patients in each group.The research group was treated with laparoscopic repair surgery,and the control group was treated with direct open repair surgery,to observe and compare the intraoperative and postoperative situations of the two groups.Results Operation time,incision length,perioperative bleeding and intraoperative time looking for lesions in the research group were obviously less than those in the control group（P 0.05）.Postoperative pain score,anus exhaust time,bed time and hospital stays in the research group were obviously lower than those in the control group（P 0.05）.Postoperative complication rate of the research group was 0.0%,significantly lower than that（11.1%） of the control group（P 0.05）.Conclusion Laparoscopic repair surgery is a relative ideal procedure for upper digestive tract perforation,which has high safety,small trauma and faster recovery and is worthy of clinical application.