中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2012年
8期
5-7
,共3页
消化性溃疡穿孔%腹腔镜%回顾性研究
消化性潰瘍穿孔%腹腔鏡%迴顧性研究
소화성궤양천공%복강경%회고성연구
Peptic ulcer perforation%Laparoscopes%Retrospective studies
目的 评价胃十二指肠溃疡穿孔修补术中腹腔镜手术是否优于传统开腹手术.方法 回顾性分析143例上消化道溃疡穿孔修补术患者,其中腹腔镜组98例,开腹组45例.手术方法包括单纯间断缝合或带蒂大网膜补片填塞缝合修补.术后常规使用质子泵抑制剂、β-内酰胺类抗生素及甲硝唑三联抗溃疡治疗.对比分析两组患者的临床疗效.结果 腹腔镜组手术时间明显长于开腹组[(83.88±19.67) min比(63.33±12.06) min],肛门排气时间、住院时间、住院费用、镇痛剂用量均明显少于开腹组[(29.45±9.24)h比(46.40±49.21)h、(6.92±1.06)d比(7.71±2.48)d、(6929.39±832.40)元比(7546.67±1393.92)元、(5.7±8.3) mg比(10.9±9.5) mg],两组比较差异有统计学意义(P＜0.01)；两组患者穿孔直径、穿孔部位、腹腔引流量比较差异无统计学意义(P＞0.05).腹腔镜组并发症发生率为14.29％( 14/98),开腹组为26.67％(12/45),两组比较差异无统计学意义(P＞0.05).结论 腹腔镜上消化道溃疡穿孔修补术是一种安全可行而更加经济的手术方法.尽管手术时间较开腹手术长,但并未增加术后并发症发生率.
目的 評價胃十二指腸潰瘍穿孔脩補術中腹腔鏡手術是否優于傳統開腹手術.方法 迴顧性分析143例上消化道潰瘍穿孔脩補術患者,其中腹腔鏡組98例,開腹組45例.手術方法包括單純間斷縫閤或帶蒂大網膜補片填塞縫閤脩補.術後常規使用質子泵抑製劑、β-內酰胺類抗生素及甲硝唑三聯抗潰瘍治療.對比分析兩組患者的臨床療效.結果 腹腔鏡組手術時間明顯長于開腹組[(83.88±19.67) min比(63.33±12.06) min],肛門排氣時間、住院時間、住院費用、鎮痛劑用量均明顯少于開腹組[(29.45±9.24)h比(46.40±49.21)h、(6.92±1.06)d比(7.71±2.48)d、(6929.39±832.40)元比(7546.67±1393.92)元、(5.7±8.3) mg比(10.9±9.5) mg],兩組比較差異有統計學意義(P＜0.01)；兩組患者穿孔直徑、穿孔部位、腹腔引流量比較差異無統計學意義(P＞0.05).腹腔鏡組併髮癥髮生率為14.29％( 14/98),開腹組為26.67％(12/45),兩組比較差異無統計學意義(P＞0.05).結論 腹腔鏡上消化道潰瘍穿孔脩補術是一種安全可行而更加經濟的手術方法.儘管手術時間較開腹手術長,但併未增加術後併髮癥髮生率.
목적 평개위십이지장궤양천공수보술중복강경수술시부우우전통개복수술.방법 회고성분석143례상소화도궤양천공수보술환자,기중복강경조98례,개복조45례.수술방법포괄단순간단봉합혹대체대망막보편전새봉합수보.술후상규사용질자빙억제제、β-내선알류항생소급갑초서삼련항궤양치료.대비분석량조환자적림상료효.결과 복강경조수술시간명현장우개복조[(83.88±19.67) min비(63.33±12.06) min],항문배기시간、주원시간、주원비용、진통제용량균명현소우개복조[(29.45±9.24)h비(46.40±49.21)h、(6.92±1.06)d비(7.71±2.48)d、(6929.39±832.40)원비(7546.67±1393.92)원、(5.7±8.3) mg비(10.9±9.5) mg],량조비교차이유통계학의의(P＜0.01)；량조환자천공직경、천공부위、복강인류량비교차이무통계학의의(P＞0.05).복강경조병발증발생솔위14.29％( 14/98),개복조위26.67％(12/45),량조비교차이무통계학의의(P＞0.05).결론 복강경상소화도궤양천공수보술시일충안전가행이경가경제적수술방법.진관수술시간교개복수술장,단병미증가술후병발증발생솔.
Objective To evaluate the effect of laparoscope and open repair on treating upper gastrointestinal (UGI) ulcer perforation.Methods Retrospective analysis was performed in consecutive series of 143 patients undergoing UGI ulcer perforation repairing.Among the total 143 patients,98 cases underwent laparoscope repair (laparoscope group),45 cases were with open repair (open group).The operation methods included either simple interrupted suture or pedicled omental patch.Postoperative management of triple therapy included proton pump inhibitor,β -lactam antibiotics and arilin was conducted.Therapeutic effects were compared between two groups.Results Operating time in laparoscope group was significantly longer than that in open group [ ( 83.88 ± 19.67 ) min vs.( 63.33 ± 12.06) min,P ＜ 0.01 ].Time of passage of gas by anus,hospital stay,cost of hospitalization and postoperative dosage of opiates in laparoscope group were significantly lower than those in open group [ (29.45 ± 9.24) h vs.( 46.40 ± 49.21 )h,(6.92 ± 1.06) d vs.(7.71 ± 2.48 ) d,(6929.39 ± 832.40) yuan vs.(7546.67 ± 1393.92) yuan,(5.7 ±8.3 ) mg vs.( 10.9 ± 9.5 ) mg,P＜ 0.01 ].There was no significant difference between two groups in perforated diameter,perforated position and flushing dose of abdominal cavity (P＞ 0.05 ).The rate of complication was 14.29％ (14/98) in laparoscope group,while 26.67％ (12/45) in open group,there was no significant difference between two groups (P＞ 0.05 ).Conclusions Laparoscope repair of UGI ulcer perforation is a safe and feasible procedure compared with open repair.Although operating time of laparoscope repair is longer than open repair,the rate of complication does not increase.
