摘要
目的比较腹腔镜与传统开腹修补上消化道穿孔的优缺点,为临床治疗手术方式的选择提供依据。方法选择2016年12月—2018年1月本院收治的92例手术治疗上消化道穿孔患者作为研究对象,按照手术方法不同分为腹腔镜组(LR组,45例)与开腹组(OR组,47例)两组。比较两组患者手术时间、腹腔脓液量、切口长度、术中出血量、下床活动时间、术后肛门排气时间、住院时间、拔出引流管时间等,以及术后常见的并发症(肺部感染、肠梗阻、肠瘘、穿孔处感染或切口感染、腹腔脓肿等)的发生率和疼痛程度评分。结果腹腔镜组患者的腹腔积液量、手术时间均高于开腹组,差异无统计学意义(P>0.05);而腹腔镜组患者的切口长度、术中出血量均小于开腹组,差异有统计学意义(P<0.05);腹腔镜组患者的下床活动时间、肛门通气时间、住院时间、拔出引流管时间均小于开腹组,差异有统计学意义(P<0.05);腹腔镜组患者术后并发症发生率低于开腹组,差异有统计学意义(P<0.05);腹腔镜组患者术后1天、术后2天、术后3天疼痛程度评分均显著低于开腹组,差异有统计学意义(P<0.05)。结论腹腔镜组(LR)与开腹组(OR)相比具有创伤小、术后恢复快、术后并发症少、住院时间短等优势,在治疗上消化道穿孔方面,腹腔镜上消化道穿孔修补术可能是一种安全且有效的手术方式。
Objective To compare the advantages and disadvantages of laparoscopic and traditional laparotomy in upper gastrointestinal perforation,and to provide basis for clinical choice of surgical methods.Methods 92 cases of patients underwent surgery due to upper gastrointestinal perforation in our hospital during December 2016 and January 2018 were enrolled as study subjects.According to the surgical method they were divided into laparoscopic repairgroup(LR group,45 case)and open repair(OR group,47 cases)group.The operation time,intraperitoneal pus volume,incision length,intraoperative bleeding amount,time needed since surgery till exercise,postoperative anal exhaust time,hospitalization time,time needed till drainage tube removal were compared between the two groups.The incidence of common postoperative complications(lung infection,intestinal obstruction,intestinal fistula,perforation infection or incision infection,abdominal abscess,etc.)and pain score of the two groups were compared.Results The amount of peritoneal effusion and operation time in the laparoscopic group were higher than those in the open group,however,the differences were not statistically significant(P>0.05).The incision length and intraoperative blood loss in the laparoscopic group were smaller than those in the open group,and the differences were statistically significant(P<0.05).The ambulation time,anal exhaust time,hospital stay and drainage tube removal time of the laparoscopic group were significantly shorter than those of the open group(P<0.05).The incidence of postoperative complications in the laparoscopic group was lower than that in the open group,and the difference was statistically significant(P<0.05).The pain scores of patients in the laparoscopic group at 1st day,2nd day and 3rd day after operation were significantly lower than those in the open group,and the differences were statistically significant(P<0.05).Conclusions Compared with the open group,the laparoscopic group has the advantages of less trauma,faster recovery,less postoperative complications and shorter hospital stay.In the treatment of upper gastrointestinal perforation,laparoscopic upper gastrointestinal perforation repair may be a safe and effective method of surgery.
作者
李阳
张义胜
Li Yang;Zhang Yisheng(Yijishan hospital of Wannan Medical College,Wuhu,Anhui,241000,China)
出处
《齐齐哈尔医学院学报》
2022年第22期2132-2136,共5页
Journal of Qiqihar Medical University
关键词
上消化道穿孔
腹腔镜上消化道穿孔修补术
开腹上消化道穿孔修补术
Upper gastrointestinal perforation
Laparoscopic upper gastrointestinal perforation repair
Open upper gastrointestinal perforation repair
