腹腔镜胃十二指肠穿孔修补术与传统开腹手术的临床疗效比较

目的比较分析腹腔镜胃十二指肠穿孔修补术与传统开腹胃十二指肠穿孔修补术的临床疗效。方法回顾分析我院普外科2012年1月-2013年4月收治的64例行不同方式胃十二指肠溃疡穿孔修补术患者的临床资料,其中实施腹腔镜手术的患者34例（腹腔镜组）,实施开腹手术的患者30例（开腹组）,对比分析两组患者的住院时间、住院费用、手术时间、术中出血量、排气时间、术后镇痛药物使用率及术后并发症发生情况等指标。结果两组患者均顺利完成手术治愈出院,腹腔镜组无中途转开腹手术的病例。开腹组在手术时间及住院费用方面低于腹腔镜组（P〈0.05）,而腹腔镜组在住院时间、术中出血量、排气时间、术后镇痛药使用率及并发症发生等方面明显低于开腹组（P〈0.05）。结论对于胃十二指肠急性穿孔修补术而言,腹腔镜手术较传统开腹手术对患者损伤更小,恢复更快,安全性更高,值得临床推广使用。

Comparison of clinical efficacy of laparoscopoic surgery and traditional laparotomy for gastroduodenal perforation repair

Objective To compare the clinical efficacy of laparoscopoic gastroduodenal perforation repair and traditional laparotomic gastroduodenal perforation repair. Methods Clinical information of 64 patients admitted to the surgical department of our hospital from January 2012 to April 2013 who received different approaches of gastroduodenal perforation repair was analyzed respectively, of which 34 patients received laparoscopoic surgery（laparoscopic group） and30 patients received laparotomic surgery（laparotomic group）. The length of hospital stay, hospital costs, operative time,intraoperative blood loss, exhaust time, postoperative usage rate of analgesic drugs and incidence of postoperative complications were analyzed comparatively. Results Both groups of patients completed the surgery successfully and were cured and discharged from hospital. None in the laparoscopic group transferred to laparotomy in the middle. The laparotomic group was lower than the laparoscopic group in the operative time and hospital costs（P〈0.05）, but the laparoscopic group was significantly lower than the laparotomic group in the length of hospital stay, intraoperative blood loss,exhaust time, postoperative usage rate of analgesic drugs and incidence of complications（P〈0.05）. Conclusion In terms of acute gastroduodenal perforation repair, laparoscopoic surgery causes smaller injury, enables faster recovery and has higher safety than traditional laparotomic surgery, thereby worthy of clinical promotion and application.