摘要
目的探讨胃十二指肠溃疡患者的微创手术修补效果。方法前瞻性研究2014年3月至2017年3月106例胃十二指肠溃疡患者不同手术方法效果,根据数字表法随机将患者分为开腹组和腹腔镜组,每组53例。采用SPSS 15.0软件进行统计分析,两组患者术中术后各项指标及疼痛评分的比较采用(±s)表示,组间比较采用独立t检验;两组的近远期并发症发生率、复发率比较采用χ~2检验,P<0.05表示差异有统计学意义。结果腹腔镜组患者的手术时间、术中出血量、术后1天、术后3天的疼痛评分及术中芬太尼用量均低于开腹组,差异具有统计学意义;腹腔镜组患者的术后近期并发症发生率3.8%低于开腹组18.9%(χ~2=5.957,P=0.015),术后1年远期并发症发生率3.8%也低于开腹组24.5%(χ~2=9.308,P=0.002),差异均具有统计学意义;开腹组1年内胃十二指肠溃疡复发7例,复发率为13.2%,腹腔镜组1年内胃十二指肠溃疡复发1例,复发率1.9%,两组患者的胃十二指肠溃疡复发率的差异具有统计学意义(χ~2=4.821,P=0.028)。结论微创腹腔镜疗法应用于胃十二指肠溃疡患者的治疗可以缩短手术时间,减少术中出血量,降低术后和远期并发症,减少术后疼痛,值得临床推广。
Objective To investigate the effect of minimally invasive surgery on patients with gastroduodenal ulcer. Methods 106 patients with gastroduodenal ulcer from March 2014 to March 2017 were prospectively studied. Patients were randomly divided into open group and laparoscopic group according to digital table method,each 53 cases. SPSS 15. 0 software was used for statistical analysis. The comparison of the intraoperative and postoperative data and pain scores between the two groups was indicated by（x± s）,comparedwith independent t test,the χ^2 test was used to compare the incidence of short-term and long-term complications and recurrence rates between the two groups. P 〈0. 05 indicated statistically significant difference. Result The operative time,intraoperative blood loss,postoperative 1 day and postoperative 3 days pain scores and intraoperative fentanyl dose in the laparoscopic group were lower than those in the open group,the difference was statistically significant; The incidence of postoperative short-term complications in the laparoscopic group was 3. 8% which was lower than in the open group 18. 9%（ χ^2= 5. 957,P =0. 015）,the incidence of long-term complications after one year was 3. 8%,which was also lower than that of open group（24. 5%）（ χ^2= 9. 308,P = 0. 002）,the differences were statistically significant. In the open group,there were 7 cases of recurrent gastroduodenal ulcer with a recurrence rate of 13. 2%,in the laparoscopic group,there was one recurrence of gastroduodenal ulcer within one year,with a recurrence rate of 1. 9%, the difference in the recurrence rate of gastroduodenal ulcer between the two groups was statistically significant（ χ^2= 4. 821,P = 0. 028）. Conclusion The application of minimally invasive laparoscopic therapy in patients with gastroduodenal ulcer can shorten the operation time,reduce the amount of intraoperative blood loss,reduce postoperative and long-term complications,reduce postoperative pain,which deserves clinical promotion.
作者
杜刚
杨林
康乐斯基
唐正勇
Du Gang;Yang Lin;Kang Le-si-ji;Tang Zhengyong(Surgery Dept;Endoscopy Room,3Medical Gastroenterology,Aba Prefecture People＇s Hospital,Aba Siehuan,624000)
出处
《中华普外科手术学杂志（电子版）》
2018年第3期238-241,共4页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
基金
四川卫计委科研项目资助(160342)~~
关键词
消化性溃疡
腹腔镜
外科手术
微创性
Peptic Ulcer
Laparoscopes
Surgical Procedures
Minimally Invasive
