腹腔镜在胃十二指肠溃疡穿孔治疗中的应用  

Laparoscopy in Management of Peptic Ulcer Perforation

作　　者：马德奎[1] 张少华[1] 彭和平[2] 任朝林[1] 韦兴中[1] 

机构地区：[1]肇庆医学高等专科学校外科教研室暨附属医院外科,肇庆526020 [2]广州医学院第二附属医院普通外科,广州510260

出　　处：《中国现代手术学杂志》2005年第1期14-16,共3页Chinese Journal of Modern Operative Surgery

摘　　要：目的　探讨腹腔镜在胃十二指肠溃疡穿孔治疗中的临床应用价值。　方法　回顾性分析腹腔镜手术组(99例)和开腹手术组(57例 )的临床资料和治疗效果。腹腔镜组包括医用ZT胶粘补溃疡穿孔 88例、穿孔缝合及大网膜覆盖修补术 11例,其中 6例同时行壁细胞迷走神经切断术 (partietalcellvagotomy, PCV);开腹手术组采用传统缝合修补术。　结果　腹腔镜组与传统开腹手术组在平均手术时间、术后一般恢复情况、腹腔平均引流量、术后并发症及治愈率上无显著性差异 (P>0. 05 )。而两组住院时间分别为(9. 2±4. 1)d和(11. 7±3. 2 )d,开腹手术组长于腹腔镜组 (P<0. 05 )。　结论　腹腔镜下行溃疡穿孔医用ZT胶粘补术、缝合修补术及PCV,具有微创的特点,操作较为简单,可望替代传统开腹溃疡穿孔修补术,但在手术方式上应注意适应证的选择。Objective To assess laparoscopy in the surgi ca l treatment for the perforated gastroduodenal ulcer. Methods 57 cases underwent suture repair under direct vision were assigned to open surgery group (group Ⅰ), 99 cases underwent laparoscopic surgery were assigne d to laparoscopy group (group Ⅱ) which including ZT medical glue repair in 88 c ases, suture repair and omemtum covering in 11 cases of which 6 cases underwent parietal cell vagotomy(PCV). Results There was no signif icant statistic difference in operating time, postoperative general condition, d rainage situation, complications, cure rate between two groups ( P >0.05). How ever, the hospital stay was significantly shorter in group Ⅱ comparing with gro up Ⅰ( P <0.05). Conclusion Laparoscopic management pr ovides a safe and efficient minimally invasive method for peptic ulcer perforati on, while the indication must be identified strictly.

关 键 词：胃十二指肠溃疡穿孔 壁细胞迷走神经切断术 溃疡穿孔修补术 医用ZT胶 临床应用价值 平均手术时间 传统开腹手术 腹腔镜手术 回顾性分析 大网膜覆盖 显著性差异 术后并发症 缝合修补术 治疗效果 临床资料 恢复情况 住院时间 

分 类 号：R656.6[医药卫生—外科学]