腹腔镜治疗胃十二指肠溃疡急性穿孔的效果  

Laparoscopic treatment of acute perforation of gastroduodenal ulcer

作　　者：王存生 张晋岗 周树理[1] 庞天骄 薛振峰[2] Wang Cunsheng ; Zhang Jingang; Zhou Shuli; Pang Tianjiao ;Xue Zhenfeng(Department of General Surgery, General Armed Police Hospital in Shanxi, Taiyuan 030006, China; Taiyuan Central Hospital of Shanxi Province, Taiyaun 030009, China)

机构地区：[1]武警山西总队医院,山西太原0300061 [2]山西省太原市中心医院,030009

出　　处：《临床医学》2018年第9期51-53,共3页Clinical Medicine

摘　　要：目的探讨腹腔镜治疗胃十二指肠溃疡急性穿孔的效果。方法选取2010年1月至2018年1月的胃十二指肠溃疡急性穿孔患者210例,均给予腹腔镜下行胃十二指肠溃疡穿孔修补术。结果 210例患者中202例行单纯修补加大网膜覆盖术,5例行生物胶黏堵修补术、3例行单纯缝合修补加迷走神经切断术,均取得满意的效果。210例患者的穿孔直径在3～8 mm,平均6 mm,腹腔积液量在60～420 ml,术中出血量7～12 ml,平均10 ml,手术持续时间60～90 min。术后继续给予禁饮食、胃肠减压、抗炎、抑酸、补液等对症治疗。术后48 min～2 h排气后给予拔除胃肠减压管,嘱其进饮食,平均约1周后出院。随访半年未出现并发症。结论腔镜技术及其设备不断改进,腔镜技术在治疗胃十二指肠溃疡急性穿孔方面效果较好,推荐临床应用。Objective To investigate the effect of laparoscopic treatment for acute perforation of gastroduodenal ulcer. Methods A total of 210 patients with acute perforation of gastroduodenal ulcer from January 2010 to January 2018 were treated with laparoscopic gastroduodenal ulcer repair. Results There were 202 cases in 210 patients underwent simple repair plus omentum coverage, 5 cases underwent bioadhesive repair, 3 cases underwent simple suture repair plus vagotomy, and achieved saris- factory results. The perforation diameters of 210 patients ranged from 3 mm to 8 ram, with an average of 6 mm. The peritoneal effusion volume ranged from 60 ml to 420 ml. The intraoperative bleeding volume ranged from 7 ml to 12 ml, with an average of 10 ml. After the operation, the patients were given the following treatments ： forbidden diet, gastrointestinal decompression, anti - inflammatory, acid suppression and fluid replacement. Gastrointestinal decompression tube was removed 48 min to 2 hours after operation and ordered to eat. On average, the patient was discharged about 1 week later. No complications occurred during the follow - up period. Conclusions Endoscopic technique and its equipment have been improved continuously. Endoscopic technique is effective in treating acute perforation of gastroduodenal ulcer. It is recommended for clinical application.

关 键 词：胃十二指肠溃疡 急性穿孔 腹腔镜 

分 类 号：R656.62[医药卫生—外科学]