腹腔镜胃十二指肠溃疡穿孔修补的优势和手术体会  

Advantage of laparoscopic repair in the perforated gastroduodenal ulcer and surgical experience

作　　者：潘平东[1] 钟强文[1] 常春[1] 

机构地区：[1]嘉应学院医学院附属医院普通外科,广东梅州514031

出　　处：《岭南现代临床外科》2015年第1期56-59,共4页Lingnan Modern Clinics in Surgery

摘　　要：目的探讨腹腔镜治疗急性上消化道穿孔的临床疗效及优点。方法选取2011年1月至2013年12月收治的急性上消化道穿孔确诊患者,年龄26-75岁,平均56.8岁,行腹腔镜修补术43例（腔镜组）,开腹修补术40例（开腹组）,记录并对比两组的手术时间、寻找病灶时间、术后排气时间、住院时间、术后疼痛评分、并发症等情况。结果所有病例均随访6-18个月,平均14.6个月,两组均无围手术期死亡病例和严重并发症;两组的手术时间无明显差异,但在手术中寻找病灶时间、术后排气时间、住院时间、术后疼痛评分和并发症发生率等方面,腹腔镜组明显优于开腹组（P〈0.05）。结论腹腔镜下行急性上消化道穿孔修补术损伤小、术后恢复快,可成为胃十二指肠穿孔修补手术的首发选择。Objective To investigate the efficacy and benefits of laparoscopy in treatment of acute upper gastrointestinal perforation. Methods Eighty-three patients with acute upper gastrointestinal perforation were treated from January 2011 to December 2013 in whom 43 cases were treated by laparoscopic surgical repair（laparoscopic group） and 40 cases by open surgery repair（open group）.The average age was 56.8 years（26-75years）. The operation time, time from operation beginning to find the focus,postoperative exhaust time,hospitalization time,postoperative pain score and complications were recorded and compared between two groups. Results All cases were followed up for 6-18 months（average 14.6 months）. No death and severe complications in perioperative period occurred in two groups. The time of finding focus, postoperative exhaust time, hospitalization time,postoperative pain score and complications in laparoscopic group were superior to that in control group.Conclusion The surgical procedure of laparoscopic surgical repair for treatment of acute upper gastrointestinal perforation has advantage of open operation, and may act as the first choice for acute upper gastrointestinal perforation.

关 键 词：上消化道穿孔 腹腔镜 修补术 

分 类 号：R656.6[医药卫生—外科学]