腹腔镜下上腹部带血管蒂肝圆韧带修补十二指肠巨大穿孔的临床应用研究  

Clinical Study of Laparoscopic Epigastric Repair of Duodenal Giant Perforation with Vascularized-pedicled Teres Hepatis Ligament

作　　者：罗特东[1] Luo Tedong(Foshan First People's Hospital,Foshan 510000,Guangdong Province,China)

机构地区：[1]佛山市第一人民医院,广东佛山510000

出　　处：《中外医药研究》2023年第26期15-17,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

基　　金：佛山市卫生健康局医学科研课题(编号:20210295)。

摘　　要：目的:研究腹腔镜下上腹部带血管蒂肝圆韧带修补十二指肠巨大穿孔的临床应用。方法:选取2021年6月—2022年6月佛山市第一人民医院收治的十二指肠巨大穿孔患者80例作为试验对象,采用随机数字表法分为对照组与观察组,各40例。对照组患者采取腹腔镜下大网膜覆盖修补治疗,观察组患者采取腹腔镜下上腹部带血管蒂的肝圆韧带修补治疗。比较两组手术情况、术后并发症发生情况、术后胃肠动力恢复情况。结果:观察组术中出血量、手术时间、引流量、引流时间、缝合时间、缝合过程中出血量均优于对照组,差异有统计学意义(P<0.05);两组术后总并发症发生率比较,差异无统计学意义(P>0.05);观察组肠鸣音恢复时间、肛门排气时间、胃肠减压解除时间均短于对照组,差异有统计学意义(P<0.001)。结论:腹腔镜下上腹部带血管蒂肝圆韧带修补十二指肠巨大穿孔能有效改善手术指标,并发症少,可促进患者胃肠功能的快速恢复。Objective:To study the therapeutic effect of laparoscopic epigastric repair of duodenal giant perforation with vascular⁃ized-pedicled teres hepatis ligament.Methods:80 patients with duodenal giant perforation admitted to the First People's Hospital of Foshan City from June 2021 to June 2022 were selected as the test subjects,and were divided into the control group and the ob⁃servation group using the randomized numerical table method,each with 40 cases.The patients in the control group were treated with laparoscopic repair of the greater omentum covering,and the patients in the observation group were treated with laparoscopic hepatic round ligament repair.Operation process,occurrence of postoperative complications and recovery of gastrointestinal dy⁃namics after operation were compared in both groups.Results:Intraoperative bleeding,operation duration,drainage flow volume,drainage duration,suture length,and bleeding volume during suture were all better in the observation group than those in the con⁃trol group,and the difference was statistically significant(P<0.05);the total postoperative complication rate of the two groups was compared,and the difference was not statistically significant(P>0.05);the time for the return of intestinal sounds,the time for anal evacuation,and the time to withdraw gastrointestinal decompression in the observation group were shorter than those in the con⁃trol group,and the difference was statistical significance(P<0.001).Conclusion:Laparoscopic repair of huge duodenal perforation by epigastric hepatic round ligament with vascular tibia can effectively improve the surgical indexes,with fewer complications,and can promote the rapid recovery of gastrointestinal function of patients.

关 键 词：腹腔镜 肝圆韧带 十二指肠巨大穿孔 胃肠动力 并发症 

分 类 号：R65[医药卫生—外科学]