急診腹腔鏡微創手術治療胃十二指腸潰瘍穿孔的效果

姜奕楊+譚英生+吳德愛

[摘要]目的 探討急診腹腔鏡微創手術治療胃十二指腸潰瘍穿孔的臨床效果。方法 選取2009年10月～2017年9月我院收治的92例胃十二指腸潰瘍急性穿孔患者進行回顧性分析，按照治療方法的不同分為觀察組和對照組，每組各46例。對照組患者采用傳統開腹手術，觀察組患者采用腹腔鏡微創手術，對兩組患者手術時間、術中出血量、肛門排氣時間、住院時間以及術后并發癥發生情況進行比較。結果 觀察組患者手術時間長于對照組（P<0.05）；觀察組術中出血量少于對照組（P<0.05）；觀察組肛門排氣時間、住院時間短于對照組（P<0.05）；觀察組患者并發癥發生率為2.2%（1/46），顯著低于對照組的10.9%（5/46），差異均有統計學意義（P<0.05）。結論 行腹腔鏡微創手術治療胃十二指腸潰瘍穿孔的效果確切，能夠有效減少手術損傷，加速患者術后康復，也能降低并發癥發生率，值得臨床推廣和應用。

[關鍵詞]急診；腹腔鏡；微創手術；胃十二指腸潰瘍穿孔

[中圖分類號] R656.6 [文獻標識碼] A [文章編號] 1674-4721（2018）1（c）-0030-03

Effect of emergency laparoscopic minimally invasive surgery treatment perforation of gastroduodenal ulcer

JIANG Yi-yang TAN Ying-sheng WU De-ai

Department of General Surgery，Chudong Hospital of Yugan County，Jiangxi Province，Yugan 335100，China

[Abstract]Objective To explore the clinical effect of minimally invasive laparoscopic minimally invasive surgery in the treatment of gastroduodenal ulcer perforation.Methods 92 patients with acute gastroduodenal ulcer who were treated in our hoptipal from October 2009 to September 2017 were retrospectively analyzed，and they were divided into observation group and control group （n=46） according to different treatments.The patients in the control group were treated with traditional laparotomy.The patients in the observation group were treated with minimally invasive laparoscopic minimally invasive surgery.The operation time，intraoperative blood loss，anal exhaust time and hospitalization time were compared between the two groups，and the postoperative complications were compared between the two groups.Results The operation time of observation group was longer than that of the control group（P<0.05）；intraoperative blood loss in the observation group was lesser than that in the control group（P<0.05）；the observation group anal exhaust time，hospitalization time was shorter than that in the control group （P<0.05）；observation group patients with complication rate was 2.2%（1/46），significantly lower than the control group 10.9%（5/46），the differences were statistically significant（P<0.05）.Conclusion Laparoscopic minimally invasive surgery for the treatment of gastroduodenal ulcer perforation is effective，can effectively reduce the surgical injury，accelerate the rehabilitation of patients after surgery，while reducing the incidence of complications，worthy of clinical promotion and application.

[Key words]Emergency；Laparoscopic；Minimally invasive surgery；Gastroduodenal ulcer perforation

胃十二指腸潰瘍穿孔是臨床常見的一類急腹癥，臨床上患者主要表現為上腹部劇烈疼痛、嘔吐等癥狀，嚴重者甚至會出現中毒性休克[1-2]。目前臨床對此類疾病的治療仍以手術為主，但傳統的開腹手術對患者造成損傷較大，影響術后恢復，且并發癥發生率較高[3-4]。隨著腹腔鏡的廣泛應用，腹腔鏡下微創手術治療胃十二指腸潰瘍急性穿孔也成為了一種新的選擇，但在急診手術中該方案的效果及安全性仍有爭議[5-6]。本文對胃十二指腸潰瘍穿孔患者實施急診腹腔鏡手術臨床效果的探討，現報道如下。endprint

1資料與方法

1.1一般資料

選取2009年10月～2017年9月我院收治的92例胃十二指腸潰瘍急性穿孔患者進行回顧性分析，按照治療方法的不同分為觀察組和對照組，各46例。觀察組男25例，女21例；年齡18～68歲，平均（43.2±7.9歲）；病程2～16 h，平均（6.4±2.1）h。對照組男24例，女22例；……