生物蛋白胶在腹腔镜治疗消化性溃疡穿孔中的应用

目的 探讨生物蛋白胶在腹腔镜治疗消化性溃疡穿孔中的应用价值.方法 选择消化性溃疡穿孔患者126例,按入院次序随机分成观察组和对照组各63例.对照组作常规修补,观察组按对照组修补方法完成修补后在修补处喷涂生物蛋白胶.比较两组术后引流量、拔管时间、消化道瘘发生率、肠粘连发生率、过敏反应及平均住院天数.结果 观察组未发生过敏反应;其术后引流量为(65.3±7.5)mL,显著低于对照组的(110.2±9.6)mL(P＜0.01).观察组无肠瘘及肠粘连发生;对照组经口服造影剂证实修补处有渗漏4例(4/63),均经B超引导下穿刺引流后痊愈.对照组术后肠粘连2例(2/63),均经非手术治疗后好转.两组并发症比较,差异有统计学意义(P＜0.05).观察组拔管时间为(25.4±3.2)h,显著低于对照组的(49.4±3.5)h(P＜0.01).观察组平均住院天数为(4.3±1.2)d,显著低于对照组的(6.5±1.4)d(P＜0.01).结论 生物蛋白胶应用于腹腔镜消化性溃疡穿孔修补术中,在封闭创面、促进溃疡愈合、预防胃或肠瘘及肠粘连等方面的效果确切,且无不良反应,值得临床推广.

Feasibility of biomedical fibrin glue in laparoscopic repair of peptic ulcer |perforation

Objective: To investigate the feasibility of biomedical fibrin glue in laparoscopic treatment of peptic ulcer perforation.
Methods: A total of 126 patients with peptic ulcer perforation were randomly divided into two groups (63 in each group).Biomedical fibrin glue was used in treatment group, and routine treatment was used in control group.The total volume of drainage after operation,rate of intestnial fistula and adhesions, allergy reaction,time of drainage tube removal,and average hospotal stay time were observed in both groups.
Results: There was no allergic reaction in treatment group.Total volume of drainage in treatment group was(65.3±7.5)mL,and (110.2±9.6)mL in control group,with a significant difference between the two groups(P<0.01).Four  fistula occurred in control group and none in treatment group (P<0.05).Time of drainage tube removal was (25.4±3.2)h in treatment group, and (49.4±3.5)h in control group (P<0.01).Average hospital stay time was (4.3±1.2)d in treatment group, and(6.5±1.4)d in control group (P<0.01).
Conclusions: Use of biomedical fibrin glue has a difinite effect on laparoscopic repair of peptic ulcer perforation; it can seal the injured site, promote ulcer healing and prevent gastric or intestinal leakage and intestinal adhesions, There are no allergic reactions associated with its use.