摘要
目的:探讨腹腔镜下穿孔修补术治疗急性十二指肠球溃疡穿孔患者的临床效果。方法:回顾性分析2018年7月—2020年2月我院收治的120例急性十二指肠球溃疡穿孔患者的临床资料,根据患者选择的手术方式不同分为两组:腔镜组、开腹组,每组各有60例患者。开腹组患者采用开腹穿孔修补术,腔镜组患者行腹腔镜下穿孔修补术。比较两组手术耗时、术中出血量、术后疼痛评分(VAS)、恢复胃肠功能时间、下床活动时间、住院时间,比较术后两组并发症发生率,检测术后不同时间点血清胃泌素(GAS)水平。结果:腔镜组患者手术耗时、术中出血量、术后疼痛评分(VAS)、恢复胃肠功能时间、下床活动时间、住院时间均较开腹组患者的明显降低,差异有显著性(P<0.05)。术后,腔镜组患者并发症发生率较开腹组患者的比较,显著降低,差异有显著性(P<0.05)。术后1天、2天、3天,两组患者血清GAS水平逐渐升高,差异有显著性(P<0.05)。与开腹组术后相同时间点比较,腔镜组患者血清GAS水平明显升高,差异有显著性(P<0.05)。结论:急性十二指肠球溃疡穿孔患者行腹腔镜下穿孔修补术可以取得满意的治疗效果,术后患者发生并发症较少、恢复较快,大力在临床推广应用的价值较高。
Objective:To explore the clinical effect of laparoscopic repair of perforation in patients with acute duodenal ulcer perforation.Methods:the clinical data of 120 patients with acute duodenal ulcer perforation admitted to our hospital from July 2018 to February 2020 were analyzed retrospectively.According to the different surgical methods selected by the patients,they were divided into two groups:endoscopic group and laparotomy group,each group had 60 patients.Patients in the laparotomy group were treated with open perforation repair,and patients in the endoscopic group were treated with laparoscopic perforation repair.The operation time,intraoperative hemorrhage,postoperative pain score(VAS),time to recover gastrointestinal function,time to get out of bed,and hospital stay were compared between the two groups.The incidence of complications and the level of serum gastrin(gas)were measured at different time points.Result:The operation time,intraoperative blood loss,postoperative pain score(VAS),recovery time of gastrointestinal function,time of getting out of bed activity and hospitalization time in the endoscopic group were significantly lower than those in the open group(P<0.05).After operation,the incidence of complications in the endoscopic group was significantly lower than that in the open group(P<0.05).On the 1st,2nd and 3rd day after operation,the serum gas level of the two groups increased gradually,with significant difference(P<0.05).Compared with the same time point after operation in the laparotomy group,the serum gas level in the endoscopic group increased significantly(P<0.05).Conclusion:Laparoscopic repair of perforation in patients with acute duodenal ulcer perforation can achieve satisfactory therapeutic effect.Postoperative complications are less and recovery is faster,so it is of great value in clinical application.
作者
杜杰
Du Jie(Beichen Hospital of Tianjin,Tianjin 300400)
出处
《黑龙江医药》
CAS
2020年第5期1166-1168,共3页
Heilongjiang Medicine journal
