腹腔镜联合胃镜治疗胃Dieulafoy病出血的临床研究  

Clinical Study of Gastroscopy and Laparoscopy in the Treatment of Gastric Dieulafoy Disease

作　　者：韩刚[1] 龚航军[1] 王以东[1] 曹羽[1] 付晓伶[1] HAN Gang;GONG Hangjun;WANG Yidong(Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai,201203)

机构地区：[1]上海中医药大学附属曙光医院,201203

出　　处：《实用癌症杂志》2018年第8期1249-1251,共3页The Practical Journal of Cancer

基　　金：国家自然科学基金青年科学基金项目(编号:81403360)

摘　　要：目的探讨腹腔镜联合胃镜治疗胃Dieulafoy病出血的疗效,并分析患者的预后。方法将62例胃Dieulafoy病出血患者,根据随机数字表法,分为治疗组(31例)和对照组(31例),分别采用腹腔镜与胃镜联合手术、开放切除术。比较2组手术指标、并发症、再出血及死亡情况。结果与对照组比较,治疗组手术时间、胃管拔除时间、排气时间、住院时间均明显缩短,术中出血量也明显减少(P<0.05);治疗组术后总并发症发生率为6.4%,明显低于对照组(25.8%)(P<0.05);治疗组再出血率为22.6%、死亡率为3.2%,对照组分别为29.0%、6.4%,差异均无统计学意义(P<0.05)。结论腹腔镜联合胃镜治疗胃Dieulafoy病在止血效果、预后等方面与开腹手术相当,且可提高手术定位准确性,减少术后并发症,促进胃肠道功能恢复。Objective To explore the effect of gastroscopy and laparoscopy in the treatment of gastric Dieulafoy disease,and the prognosis was analyzed. Methods According to the random number table,62 cases with gastric Dieulafoy disease were divided into 2 groups. The treatment group（ n = 31） and the control group（ n = 31） received gastroscopic-assisted laparoscopic surgery and open surgery,respectively. Operation related indexes,complications,rebleeding and mortality were compared. Results Compared with the control group,the evacuation time and hospitalization time were significantly shortened,and intra-operative blood loss in the treatment group were decreased（ P 〈 0. 05）. The total incidence of postoperative complications in the treatment group was significantly lower than those of the control group（ 6. 4% vs 25. 8%）（ P 〉 0. 05）. There were in significant difference on the rate of rebleeding（ 22. 6% vs 29. 0%） and mortality（ 3. 2% vs 6. 4%） between the 2 groups（ P 〉 0. 05）. Conclusion Gastroscopy and laparoscopy for gastric Dieulafoy disease has similar effect on haemostatic effect and prognosis with open surgery,and can improve the positioning accuracy,reduce postoperative complications,and promote recovery of gastrointestinal function.

关 键 词：胃DIEULAFOY病 腹腔镜 胃镜 开放手术 

分 类 号：R735.2[医药卫生—肿瘤]