摘要
目的 分析对比上消化道穿孔患者开腹手术及腹腔镜手术术后并发症的发生情况.方法 回顾性分析中国人民解放军总医院2008年1月-2017年1月收治的113例胃十二指肠穿孔患者的病例资料,其中男性100例,女性13例,年龄17 ～ 87岁,平均(51.42 ±17.11)岁,按手术方式将患者分为开腹组(64例)和腹腔镜组(49例),对术中出血量和术后并发症进行比较.计量资料用均数±标准差((-x)±s)表示,组间比较采用t检验.计数资料用率或百分比表示,组间比较采用x2检验.结果 腹腔镜组出血量为(51.90±18.91) ml,明显少于开腹组(74.60±10.23) ml(x2=8.186,P=0.000).全组113例患者术后发生并发症28例(24.8％),并发症发生率居前3位的分别是切口感染、肺炎、吻合口或修补处出血.开腹组、腹腔镜组术后并发症发生率分别为29.7％ (19/64)与18.4％ (9/49),两组间差异无统计学意义(x2=1.908,P=0.193).结论 上消化道穿孔开腹和腹腔镜手术术后并发症发生情况相当,且腹腔镜组术中出血量明显少于开腹组,但由于微创手术技术要求较高,需由有经验的医师来完成.
Objective To analyze and compare the complications of laparotomysurgery and laparoscopic surgery for upper gastrointestinal perforation.Methods Retrospective analyzed the clinical data of 113 patients,including 100 male cases,13 female cases,aged 17 to 87 years old,mean (51.42 ± 17.11) years old,with perforation in stomach and duodenum at Chinese People's Liberation Army General Hospital from January 2008 to January 2017.The patients were divided into laparotomy group (64 cases) and laparoscopic group (49 cases) according to the operation mode,and the intraoperative blood loss and postoperative complications were compared.The measurement data were expressed by ((-x) ± s),and the t test was used between the groups.The count data were expressed by ratio or percentage,the chi-square test was used.Results The amount of bleeding in laparoscopic group was (51.90 ± 18.91) ml,was significantly less than that of laparotomy group (74.60 ± 10.23) ml (x2 =8.186,P =0.000).Postoperative complications occurred in 28 patients (24.8％) in 113 patients,and the top three complications were incision infection,pneumonia,and anastomotic or patch bleeding.The incidence of postoperative complications in laparotomy group and laparoscopic group was 29.7％ (19/64) and 18.4％ (9/49),respectively,and there was no significant difference (x2 =1.908,P =0.193).Conclusion The two kinds of operation methods of upper digestive tract perforation are similar,and the amount of bleeding in laparoscopic operation group is less than that in laparotomy group,at the same time,higher technical requiremnents are need to be completed by experienced doctors for minimally invasive surgery.
出处
《国际外科学杂志》
2017年第10期677-680,共4页
International Journal of Surgery
关键词
手术后并发症
肠穿孔
上消化道穿孔
开腹手术
腔镜手术
Postoperative complications
Intestinal perforation
Upper gastrointestinal perforation
Open surgery
Endoscopic surgery
