腹腔镜下胃十二指肠穿孔修补术与开腹修补术对胃肠动力的影响研究  

Study on the Effect of Laparoscopic Minimally Invasive and Open Repair of Gastroduodenal Perforation on Gastrointestinal Motility

作　　者：佘恒海 吴卫东[1] SHE Heng-hai;WU Wei-dong(The People's Hospital of Chizhou,Chizhou,Anhui(247100),China)

机构地区：[1]池州市人民医院急诊外科,池州247100

出　　处：《中国中西医结合外科杂志》2020年第4期650-653,共4页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:研究腹腔镜下与开腹修补术治疗胃十二指肠穿孔的效果及对胃肠动力的影响。方法:选取池州市人民医院2015年6月—2017年6月收治的72例胃十二指肠穿孔患者,按手术方式分为观察组和对照组,每组36例,观察组采用腹腔镜下修补术治疗,对照组采用开腹修补术治疗。比较两组患者的手术情况、并发症发生率和术后胃肠动力恢复情况。结果:观察组的手术切口长度、手术时间、术中出血量、术后下床活动时间、住院时间均小于对照组;治疗费用则高于对照组患者,差异有统计学意义(P<0.05);观察组的术后肠鸣音恢复时间、肛门排气时间、胃肠减压解除时间均低于对照组,差异有统计学意义。观察组的术后并发症发生率为5.56%(2/36);低于对照组的19.45%(7/36),差异有统计学意义(P<0.05)。结论:开腹修补术与腹腔镜下微创修补术均能有效治疗胃十二指肠穿孔,但与开放修补术相比,腹腔镜下微创修补术具有创伤小、术后胃肠动力恢复快、手术安全性好等优点,值得进一步临床推广应用。Objective To investigate the effect of minimally invasive repair of gastroduodenal perforation and open repair and to observe the effect on gastrointestinal motility.Methods The stomach and duodenum were admitted to our hospital from June 2015 to June 2017 with perforation in 72 cases as the research objects,which were randomly classified into two groups:the observation group and the control group,36 cases in each group.The laparoscopic minimally invasive repair surgery treatment was used in observation group,while the control group were treated with open repair surgery.The operation of the patients in two groups,the incidence of complications and the recovery of gastrointestinal motility after operation were evaluated and compared.Results The patients in the observation group were operated in various indexes including blood incision length,weight,operation time,ambulation time and hospitalization time,which were lower than those in control group.The cost of treatment is higher than that of the control group.There were significant differences between the two groups(P<0.05).The observation group of patients with postoperative gastrointestinal motility index including borborygmus recovery time,anal exhaust time,gastrointestinal decompression and release time were lower than those in the control group.There were significant differences between the two groups(P<0.05).The incidence of postoperative complications in the observation group was 5.56%(2/36),while the rate of complication in the control group was 19.45%(7/36).There was significant difference between the two groups(P<0.05).Conclusion Open repair and laparoscopic minimally invasive repair areboth effective treatment of gastroduodenal perforation.However,compared with open repair,laparoscopic surgery with minimally invasive repair has small trauma,quick recovery of postoperative gastrointestinal motility,fast and safety in operation.It is worthy of further clinical application.

关 键 词：胃十二指肠穿孔 腹腔镜穿孔修补术 开放穿孔修补术 胃肠动力 

分 类 号：R656.6[医药卫生—外科学]