四孔腹腔镜穿孔修补术用于胃十二指肠溃疡急性穿孔患者的效果及安全性  

Efficacy and Safety of Four-hole Laparoscopic Perforation Repair in Patients with Acute Perforation of Gastroduodenal Ulcer

作　　者：瞿涛 QU Tao(Gastrointestinal Hernia Surgery,Liupanshui Municipal People's Hospital,Liupanshui 553000,China)

机构地区：[1]六盘水市人民医院胃肠疝外科,贵州六盘水553000

出　　处：《中国医学创新》2025年第12期21-24,共4页Medical Innovation of China

摘　　要：目的:探究胃十二指肠溃疡急性穿孔患者行四孔腹腔镜穿孔修补术的临床效果。方法:回顾性分析2022年12月—2024年12月六盘水市人民医院收治的60例胃十二指肠溃疡急性穿孔患者,按手术方式不同分两组,各30例。对照组行传统开腹修补术,观察组行四孔腹腔镜穿孔修补术。比较两组围手术期指标、疼痛程度、炎症指标及并发症发生率。结果:观察组手术时间、肛门排气时间、下床活动时间、住院时间、切口长度均较对照组短,术中出血量较对照组少,差异均有统计学意义(P<0.05);术后6、24、48 h,观察组视觉模拟评分法(VAS)评分均较对照组低,差异均有统计学意义(P<0.05);术前,两组炎症指标比较,差异均无统计学意义(P>0.05);术后1 d,观察组超敏C反应蛋白(hs-CRP)、白细胞计数(WBC)均较对照组低,差异均有统计学意义(P<0.05)。观察组并发症发生率较对照组低,差异有统计学意义(P<0.05)。结论:与传统开腹修补术比较,胃十二指肠溃疡急性穿孔患者行四孔腹腔镜穿孔修补术在优化围手术期指标、减轻炎症反应及疼痛方面效果更为显著,利于减少并发症。Objective:To investigate the clinical effect of four-hole laparoscopic perforation repair in patients with acute perforation of gastroduodenal ulcer.Method:A total 60 patients with acute perforation of gastroduodenal ulcer admitted to Liupanshui Municipal People's Hospital from December 2022 to December 2024 were retrospectively analyzed and divided into two groups according to different surgical methods,with 30 cases in each group.The control group underwent traditional laparotomy repair,and the observation group underwent fourhole laparoscopic perforation repair.Perioperative indexes,pain degree,inflammation indexes and complication rate between the two groups were compared.Result:The operation time,anal exhaust time,getting out of bed time,hospitalization time and incision length in the observation group were shorter than those in the control group,and the intraoperative blood loss was less than that in the control group,the differences were statistically significant(P<0.05).At 6,24 and 48 h after operation,visual analogue scale(VAS)scores in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Before operation,there were no significant differences in inflammation indexes between the two groups(P>0.05).On the first day after operation,the hypersensitive C reactive protein(hs-CRP)and white blood cell count(WBC)in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).The complication rate of the observation group was lower than that of the control group,the difference was statistically significant(P<0.05).Conclusion:Compared with traditional open repair,four-hole laparoscopic perforation repair for acute perforation of gastroduodenal ulcer is more effective in optimizing perioperative indexes,alleviating inflammation and pain,and reducing complications.

关 键 词：胃十二指肠溃疡 急性穿孔 四孔腹腔镜穿孔修补术 围手术期指标 疼痛程度 炎症指标 并发症 

分 类 号：R656.6[医药卫生—外科学]