腹腔镜与开腹手术在非外伤性胃及小肠穿孔中的临床疗效比较  

Comparison of the clinical eff ect of laparoscopic and open surgery in the treatment of non-traumatic gastric and small intestinal perforation

作　　者：汪洋[1] 陆贤 Wang Yang;Lu Xian(Department of General Surgery,Kunshan Traditional Chinese Medicine Hospital Affi liate to Nanjing University of Chinese Medicine,Jiangsu Suzhou 215300,China)

机构地区：[1]南京中医药大学附属昆山市中医医院普外科,江苏苏州215300

出　　处：《临床普外科电子杂志》2025年第1期7-10,20,共5页Journal of General Surgery for Clinicians(Electronic Version)

摘　　要：目的观察并比较腹腔镜手术与开腹手术在非外伤性胃及小肠穿孔中的临床疗效。方法回顾性比较并分析南京中医药大学附属昆山市中医医院2016年2月至2022年3月诊治的非外伤性胃及小肠穿孔患者的临床资料,其中行腹腔镜手术患者(腹腔镜组)53例,行开腹手术患者(开腹组)46例。比较分析两组患者性别、年龄、体质量指数、手术时长、肛门排气时间、总住院时间、术后炎症、营养状况及并发症等围手术期指标。结果两组患者年龄、性别等基本资料差异无显著性(P>0.05)。与开腹组相比,腹腔镜组手术时间更短[(55.5±21.6)min比(76.1±47.2)min,P<0.005],术后肛门排气时间更早[(3.4±1.2)d比(5.4±1.0)d,P<0.001],腹腔引流管放置时间更短[(5.8±1.2)d比(7.9±1.7)d,P<0.001],住院时间更少[(9.9±2.3)d比(13.4±4.8)d,P<0.001],总费用更低[(1.58±0.50)万元比(2.54±1.58)万元,P<0.001]。腹腔镜组患者术后3d炎症及营养指标更好(P<0.05),两组患者术后并发症发生率差异无显著性(P>0.05)。结论在符合腹腔镜手术指征的情况下,腹腔镜手术创伤更小,手术创伤更小,术后恢复快,疗效显著。Objective To observe and compare the clinical effi cacy of open surgery with laparoscopic surgery in the treatment of non-traumatic perforation of stomach and small intestine.Method The clinical data of patients with upper digestive tract perforation admitted to Kunshan Traditional Chinese Medicine Hospital Affi liate to Nan-jing University of Chinese Medicine from February 2016 to March 2022 were retrospectively analyzed.Among them,53 cases underwent laparoscopic surgery and 46 cases underwent open surgery.The perioperative indicators of the two groups,such as gender,age,body mass index,operation time,anal exhaust time,length of stay,postop-erative infl ammation,nutritional status and surgery complications were compared and analyzed.Result There was no signifi cant diff erence in preoperative basic data such as age and gender between the two groups(P>0.05).Compared with the open group,the operation time of the laparoscopic group was shorter[(55.5±21.6)min vs.(76.1±47.2)min,P<0.005].postoperative anal exhaust time was early[(3.4±1.2)d vs.(5.4±1.0)d,P<0.001],abdominal drainage tube placement time was short[(5.8±1.2)d vs.(7.9±1.7)d,P<0.001].the hospital stay was shorter[(9.9±2.3)d vs.(13.4±4.8)d,P<0.001],and the total cost was lower[(1.58±0.50)ten thousand yuan vs.(2.54±1.58)ten thousand yuan,P<0.001].In addition,the laparoscopic group had better infl ammation and nutritional indexes three days after surgery(P<0.05),and there was no signifi cant diff erence in the incidence of postoperative complications between the two groups(P>0.05).Conclusion Under the condition of the indications of laparoscopic surgery,laparoscopic surgery has signifi cant clinical eff ect,less surgical trauma,and faster postop erative recovery, which is worthy of clinical application.

关 键 词：非外伤性 胃肠穿孔 腹腔镜手术 开腹手术 临床疗效 

分 类 号：R656.1[医药卫生—急诊医学]