双视免气腹腔镜胃肠穿孔修补术的临床研究  

Double-view pneumoperitoneum-free laparoscopic-assisted repair of gastroduodenal perforation

作　　者：陈声飞[1] 胡斌[1] 邓剑[1] 李庆洪[1] 胡绚芳 

机构地区：[1]广东省博罗县人民医院普通外科,516100

出　　处：《国际医药卫生导报》2016年第16期2479-2482,共4页International Medicine and Health Guidance News

摘　　要：目的回顾性对比分析双视免气腹腔镜与开腹手术治疗老年人胃十二指肠溃疡穿孔的疗效。方法应用双视免气腹腔镜手术设备辅助下行胃十二指肠溃疡穿孔修补术88例老年患者定为观察组，同期行常规开腹胃十二指肠溃疡穿孔修补术98例老年患者为对照组。比较两组的切口长度、肛门恢复排气时间、住院时间、切口感染率、肺部感染率、胃瘘发生率、幽门梗阻发生率等指标有无差异。结果对照组切口长度为（115±27．6）mm，肛门恢复排气时间为（78．6±10.3）h，住院时间为（12．6±2．8）天，切口感染率为10．21％，肺部感染率为8．16％；观察组切口长度为（37±8．5）mm，肛门恢复排气时间为（51．5±5．4）h，住院时间为（8．5±3．5）天，切口感染率为1．13％，肺部感染率为1．13％；观察组均比对照组小，差异有统计学意义（P〈0．05）。胃瘘发生率观察组为1．13％、对照组为3．06％，差异无统计学意义（P〉0．05）。幽门梗阻发生率观察组为1．13％、对照组为2．04％，差异无统计学意义（P〉0．05）。结论相对于开腹胃十二指肠溃疡穿孔修补术，应用双视免气腹腔镜设备辅助治疗老年人胃十二指肠溃疡穿孔疗效可靠，创伤小，并发症少，术后恢复快。Objective To compare analyze the efficacy of double-view pneumoperitoneum-free laparoscopic-assisted repair versus laparotomy for elderly patients with gastroduodenal ulcer perforation. Methods 88 elderly patients with gastroduodenal perforation unertaking double-view pneumoperitoneum-free laparoscopic-assisted repair operation were set as an observation group and other 98 elderly patients treated by laparotomy during the same period a control group. The clinical outcomes, such as the length of incision, anus evacuation time, hospital stay, incision infection rate, lung infection rate, stomach leak occurrence rate, and pyloric obstruction occurrence rate were compared between these two groups. Results In the control group, the length of incision was （115±27.6） mm, the anus evacuation time （78.6±10.3） h, hospital stay （12.6±2.8）d, incision infection rate 10.21%, and lung infection rate 8.16%; in the observation group, the length of incision was （37±8.5） mm, the anus evacuation time （51.5±5.4） h, hospital stay （8.5±3.5）d, incision infection rate 1.13%, and lung infection rate 1.13%; all these indicators were much less in the observation group than in the control group（P〈0.05）. The stomach leak occurrence rate was 1.13% in the observation group and 3.06% in the control group （P〉0.05）. The pyloric obstruction occurrence rate was 1.13% in the observation group and 2.04% in the control group（P〉0.05）. Conclusions Double-view pneumoperitoneum-free laparoscopic-assisted repair for gastroduodenal perforation is safer, more feasible, and more minimally invasive and has fewer complications and quicker postoperative recovery than laparotomy.

关 键 词：双视免气腹腔镜 胃十二指肠溃疡穿孔 开腹手术 

分 类 号：R656.62[医药卫生—外科学]