腹腔镜治疗老年人消化道穿孔的疗效分析  

Laparoscopic Treatment of Elderly Patients with Perforation of Digestive Tract

作　　者：汪小龙 闫金松 WANG Xiao-long;YAN Jin-song(Department of Gastrointestinal Surgery,Huaian Hospital,Huai＇an,Jiangsu Province,223200 China)

机构地区：[1]淮安市淮安医院胃肠外科,江苏淮安223200

出　　处：《中外医疗》2018年第24期92-94,共3页China & Foreign Medical Treatment

摘　　要：目的探讨应用腹腔镜技术治疗老年人消化道穿孔的临床疗效及应用前景。方法方便选取该院于2015年5月—2017年12月收治并采用腹腔镜手术治疗的68例消化道穿孔患者进行回顾性分析,评价手术效果。结果术前明确诊断的消化道穿孔,术中探查探查确认为十二指肠球部溃疡穿孔55例,胃溃疡穿孔10例;小肠穿孔3例。所有病例均顺利完成完全腹腔镜手术操作,平均手术时间(89±5.64)min。平均出血量约(30±5.68)m L。术后(2.0±0.36)d下床活动,(2.5±0.46)d排气排便。术后腹腔残余感染1例,行B超引导下腹腔穿刺引流后1周治愈;余均顺利恢复,平均住院时间(12.0±2.14)d。术后随访6个月以上,无粘连性肠梗阻和腹腔脓肿发生。结论应用腹腔镜技术治疗老年人消化道穿孔时,具有手术切口小,疼痛轻,肠功能恢复快,并发症少等优点,值得临床推广应用。Objective To explore the clinical efficacy and application prospects of laparoscopic treatment of perforation ofdigestive tract in the elderly. Methods A retrospective analysis of 68 patients with perforation of the digestive tract treatedin the hospital in May 2015 to December 2017 treated with laparoscopic surgery was performed to evaluate the surgicaloutcome. Results The perforation of the digestive tract was clearly diagnosed before operation. Intraoperative explorationand exploration confirmed 55 cases of duodenal ulcer perforation, 10 cases of gastric ulcer perforation, and 3 cases of smallintestine perforation. All cases were successfully completed laparoscopic surgery, the average operation time （89±5.64）min.The average amount of bleeding was about （30±5.68）mL, postoperative out of bed （2.0±0.36）d, （2.5±0.46）d exhaust defecation. One case of postoperative residual infection in the abdominal cavity was cured after one week of peritoneal punctureand drainage under the guidance of B-ultrasonography. The rest of the patients recovered smoothly and the average lengthof stay was （12.0±2.14）d. After 6 months of follow-up, no adhesive intestinal obstruction or abdominal abscess occurred.Conclusion Laparoscopic treatment of elderly patients with perforation of the digestive tract has the advantages of small incision, mild pain, rapid recovery of intestinal function and fewer complications. It is worthy of clinical application.

关 键 词：消化道穿孔 腹腔镜 弥漫性腹膜炎 

分 类 号：R656.6[医药卫生—外科学]