腹腔镜修补胃十二指肠穿孔46例(1)
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[摘要] 目的 研究腹腔镜修补胃十二指肠穿孔技术与效果。 方法 对46例胃十二指肠穿孔患者作腹腔镜下穿孔修补术。同期28例胃十二指肠穿孔患者作开腹手术。比较两组的手术时间、术后胃肠道恢复、术后住院天数等指标。 结果 腹腔镜组住院日、术后下床时间、肛门恢复排气时间、最短手术时间、术后镇痛分别为(6.1±2.5)d、(7.8±4.2)h、(24.5±18.4)h、28 min、2%；与开腹组的(9.4±3.9)d、(12.9±5.9)h、(45.3±26.7)h、38 min、53.6%比较差异有统计学意义(P<0.05)。两组平均手术时间差异无统计学意义(P>0.05)，无严重并发症发生。 结论 腹腔镜胃十二指肠穿孔修补和开腹单纯缝合具有相同的手术适应证，腹腔镜下操作具有明显的微创优势，兼具腹腔镜探查和治疗双重功能，操作简单安全易推广，痛苦小、肠道功能恢复快、住院时间短。
[关键词] 腹腔镜；消化性溃疡；外科手术
[中图分类号] R656.62 [文献标识码] B [文章编号] 1673-9701(2012)01-154-03
The gastric and duodenum perforation repair with laparoscope: an analysis of 46 cases
WANG Daming ZHANG Xin ZUO Laian
Department of Surgery, Jiangsu Province Yangzhou Dongfang Hospital，Yangzhou 225012，China
[Abstract] Objective To study the technique and effectiveness of gastric and duodenum perforation repair with laparoscope. Methods 46 patients were performed gastric and duodenum perforation repair with laparoscope and the other 28 patients with gastric and duodenum perforation underwent open surgery. Clinical parameters including surgical procedure，operation time，time for passage of flatus，and hospital day in both groups were compared. Results Laparoscope treatment group hospital day，after bed time，minimum operation time，the time to intestinal function recovery，use of analgesics were(6.1±2.5)d，(7.8±4.2)h，(24.5±18.4)h，28 min，2%.Comparison with the open surgery group were (9.4±3.9)d，(12.9±5.9)h，(45.3±26.7)h，38 min，53.6%.There were differences between two groups (P<0.05). There were no significant differences in operative time. There was no intraoperative and postoperative complication. Conclusion Gastric and duodenum perforation repair with laparoscope has the same indication as open surgery. Minimally invasive operation with laparoscope has obvious advantages and dual functions of detection and treatment，taking similar time to open surgery，which is simple，safe and easy to promote. Little suffering and faster recovery after surgery.
[Key words] Laparoscope；Peptic ulcer；Surgery
胃十二指肠穿孔是腹部外科常见的急腹症，传统的手术治疗多为开腹穿孔修补术。腹腔镜在普外科择期手术中的应用越来越广，而在急腹症的应用中相对较少，近年来腹腔镜下修补穿孔渐渐受到重视。本文旨在探讨腹腔镜修补胃十二指肠穿孔技术与效果及临床应用价值。
1 资料与方法
1.1 一般资料
我院于2006年5月～2011年5月作腹腔镜下胃十二指肠穿孔修补术46例，同期完成开腹胃十二指肠穿孔修补术28例，共计74例。其中男45例，女29例，年龄17～79岁；从发病到入院时间2～74 h，其中胃溃疡继发穿孔26例，十二指肠溃疡继发穿孔47例 ......
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