胃十二指肠溃疡急性穿孔的诊断和治疗

目的探讨胃十二指肠溃疡急性穿孔的诊断和手术治疗的疗效。方法前瞻性的将2008年4月～2011年12月收治于笔者所在医院的63例胃十二指肠溃疡急性穿孔患者根据临床症状、腹部穿刺及X线检查进行诊断,确诊后随机分为两组,分别为腹腔镜组(实验组),30例,开腹组(对照组)33例,回顾性的对比分析两组手术时间、术后排气时间、住院时间、术中出血量和切口感染以及术后使用镇痛剂例数等。结果腹腔镜组在术后排气时间、住院时间、术中出血量和切口感染以及术后使用镇痛剂比例数中均明显低于开腹组(P<0.01),差异有统计学意义,但手术时间腹腔镜组明显高于开腹组(P<0.05),差异有统计学意义。结论急性胃十二指肠溃疡穿孔的修补采取腹腔镜修补进行治疗较开腹手术治疗而言具有创伤小、恢复快、住院时间短等特点,是一种治疗胃十二指肠溃疡急性穿孔的理想方案。

Diagnosis and treatment of acute gastroduodenal ulcer perforation

Objective To investigate the diagnosis and the efficacy of surgical treatment of acute gastroduodenal ulcer perforation.Methods Sixty-three patients with acute gastroduodenal ulcer perforation admitted to and treated in our hospital from April 2008 to December 2011 were diagnosed retrospectively according to the clinical symptoms,abdominal puncture and X-ray examinations.Then the patients were divided into the laparoscopic group(experimental group) with 30 patients and the laparotomy group(control group) with 33 patients.The operation time,postoperative exhaust time,hospital stay,amount of intraoperative bleeding,incision infection and the number of cases of postoperative analgesics use were compared and analyzed retrospectively.Results The laparoscopic group was obviously lower than the laparotomy group in the postoperative exhaust time,hospital stay,amount of intraoperative bleeding,incision infection and the number of cases of postoperative analgesics use,with statistically significant differences(P<0.01),but was obviously higher in the operation time,with statistically significant differences(P<0.05).Conclusion For the repair of acute gastroduodenal ulcer perforation,laparoscopy has the advantages of small trauma,early recovery and short hospital stay compared to the laparotomy,thereby is an ideal solution for the treatment of acute gastroduodenal ulcer perforation.