腹腔镜及开腹手术治疗上消化道穿孔的疗效评估  

Clinical evaluation study on laparoscopic neoplasty and open neoplasty with acute upper gastrointestinal perforation

作　　者：邓锋[1] 胡石甫[1] 郝媛媛[2] 于雅静[1] 黄晋[1] 刘宇婷[1] 邓强[1] 周慧芳[1] 

机构地区：[1]天津市西青医院普外二科,300380 [2]天津市西青医院老年病科,300380

出　　处：《临床医学》2017年第4期17-19,共3页Clinical Medicine

摘　　要：目的评估腹腔镜及开腹手术治疗急性上消化道穿孔的临床疗效。方法将65例急性上消化道穿孔患者随机分为腹腔镜组(n=31)和开腹组(n=34);腹腔镜组行腔镜下穿孔修补术,开腹组行开腹上消化道穿孔修补术,术后给予相同治疗方案。比较两种术式术后疗效、术后并发症等情况。结果在手术时间、术中出血情况、住院时间方面,腹腔镜组明显低于开腹组(P<0.05);但住院费用腹腔镜组高于开腹组(P>0.05);腹腔镜组患者术后下地活动及排气时间均早于开腹组(P<0.05);腹腔镜组患者术后各类并发症发生率明显低于开腹组(P<0.05);腹腔镜组术后疼痛程度低于后者(P<0.05)。结论腹腔镜下上消化道穿孔修补术治疗效果确切,手术操作更简单,成功率更高,术中创伤小,术后恢复更快,值得推广。Objective To discuss the clinical effect between the laparoscopic neoplasty and the open neoplasty in the treatment of acute upper gastrointestinal perforation. Methods The clinical data of 65 patients with laparoscopic neoplasty and open neoplasty were compared and analyzed, including operation time, intraoperative bleeding, out of bed activity time, VAS score （24 hours, 48 hours, 72 hours, one week） after opeartion, postoperative complications, hospitalization days and economic cost in hospital and follow-up recurrence. Results The operation time of the laparoscopic neoplasty group was slightly shorter than that of the open neoplasty group, while the overall economic cost in hospital was higher than that in the open neoplasty group （P 〉 0.05） , but there was a statistically significant difference in the operation of bleeding, postoperative lower activity and the length of stay in hospital between the two groups （ P 〈 0. 05 ）. The incidence rate of postoperative complications of the laparoscopic group was significantly lower than that of the open neoplasty group （P 〈 0.05 ）. The laparoscopic group was superior to the open neoplasty group in the reduction of postoperative pain（P 〈 0. 05）. Conclusion Laparoscopic repair of upper gastrointestinal perforation is effective, simple operation, higher success rate, less intraoperative trauma, faster postoperative recovery, it is worth promoting.

关 键 词：腹腔镜 开腹 上消化道穿孔 疗效 

分 类 号：R656[医药卫生—外科学]