腹腔镜上消化道穿孔修补术治疗上消化道穿孔的临床研究
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摘要
目的:探讨腹腔镜上消化道穿孔修补术治疗上消化道穿孔的效果及安全性。方法:选取2015年9月-2017年10月本院收治的上消化道穿孔患者80例为研究对象,根据手术方式不同将患者分为对照组(n=39)与研究组(n=41)。对照组采取传统开腹手术,研究组则采取腹腔镜上消化道穿孔修补术。观察两组手术治疗效果,比较两组患者的手术时间、术中出血量、术后引流量以及住院时间,同时对比分析两组患者相应住院费用及术后状况,并在术后,记录两组患者的并发症发生情况,对两组的安全性进行比较。结果:研究组总有效率显著高于对照组,差异有统计学意义(P<0.05)。研究组患者术中相关指标均显著优于对照组,差异均有统计学意义(P<0.05)。术后研究组患者并发症发生率显著低于对照组,差异有统计学意义(P<0.05)。研究组患者的住院费用及相应术后指标均显著优于对照组,差异均有统计学意义(P<0.05)。结论:上消化道穿孔患者采用腹腔镜上消化道穿孔修补术的治疗效果、住院时间、住院费用等均优于传统开腹手术治疗,且前者安全性较后者更高。
Objective:To investigate the efficacy and safety of laparoscopic upper gastrointestinal perforation repair for patients with perforation of the upper digestive tract.Method:Eighty patients with perforation of the upper digestive tract were selected from September 2015 to October 2017 in our hospital.Patients were divided into control group(n=39) and study group(n=41) according to different surgical methods,the control group underwent traditional laparotomy,while the study group underwent laparoscopic perforation of the upper digestive tract.The surgical treatment effect,operation time,intraoperative blood loss,postoperative drainage volume and hospitalization time of the two groups were compared,and the corresponding hospitalization cost and postoperative status of the two groups were analyzed,after the operation,the complications of the two groups were recorded,the safety of the two groups were compared.Result:The total effective rate of the study group was significantly higher than that of control group,the difference was statistically significant(P<0.05).The intraoperative relevant indicators in the study group were significantly better than those in the control group,the differences were statistically significant(P<0.05).The incidence of complications in the postoperative of study group was significantly lower than that in the control group,the difference was statistically significant(P<0.05).Hospitalization expenses and corresponding postoperative indexes of the study group were significantly better than those of the control group,with statistically significant differences(P<0.05).Conclusion:Laparoscopic upper gastrointestinal perforation repair for patients with upper gastrointestinal perforation has better therapeutic effect,length of stay and hospitalization cost than traditional open surgery,and the safety of the former is higher than that of the latter.
Objective:To investigate the efficacy and safety of laparoscopic upper gastrointestinal perforation repair for patients with perforation of the upper digestive tract.Method:Eighty patients with perforation of the upper digestive tract were selected from September 2015 to October 2017 in our hospital.Patients were divided into control group(n=39) and study group(n=41) according to different surgical methods,the control group underwent traditional laparotomy,while the study group underwent laparoscopic perforation of the upper digestive tract.The surgical treatment effect,operation time,intraoperative blood loss,postoperative drainage volume and hospitalization time of the two groups were compared,and the corresponding hospitalization cost and postoperative status of the two groups were analyzed,after the operation,the complications of the two groups were recorded,the safety of the two groups were compared.Result:The total effective rate of the study group was significantly higher than that of control group,the difference was statistically significant(P<0.05).The intraoperative relevant indicators in the study group were significantly better than those in the control group,the differences were statistically significant(P<0.05).The incidence of complications in the postoperative of study group was significantly lower than that in the control group,the difference was statistically significant(P<0.05).Hospitalization expenses and corresponding postoperative indexes of the study group were significantly better than those of the control group,with statistically significant differences(P<0.05).Conclusion:Laparoscopic upper gastrointestinal perforation repair for patients with upper gastrointestinal perforation has better therapeutic effect,length of stay and hospitalization cost than traditional open surgery,and the safety of the former is higher than that of the latter.
引文
[1]卢业才,李启信,林珺珺,等.腹腔镜与开腹手术治疗上消化道穿孔疗效的对比分析[J].安徽医学,2016,37(9):1136-1138.
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[3]闫凌.腹腔镜上消化道穿孔修补术治疗39例上消化道穿孔的效果探讨[J].中国实用医药,2016,11(11):71-72.
[4]翟长元.腹腔镜上消化道穿孔修补术32例临床治疗分析[J].心理医生,2016,22(25):110-111.
[5]王亮,折占飞,乔宇,等.腹腔镜联合胆道镜经胆囊管探查治疗胆囊结石合并胆总管结石[J].中国微创外科杂志,2017,17(2):189-192.
[6]朱金理,汪东树,潘书鸿.腹腔镜联合胆道镜治疗胆囊胆总管结石与开腹手术疗效比较的回顾性研究[J].肝胆外科杂志,2016,24(3):200-203.
[7]杨如高,连立之,张佳文.三种不同手术方式治疗胆囊结石合并胆总管结石的疗效及安全性分析[J].肝胆外科杂志,2017,25(1):30-33.
[8]刘如金.48例上消化道穿孔临床诊治分析[J].世界最新医学信息文摘,2018,18(13):81.
[9]尹洪泉,庞宏欣,刘军.腹腔镜支持手术与开腹手术治疗上消化道穿孔的并发症发生及预后对比[J].四川生理科学杂志,2018,40(2):1-6.
[10]赵杰,姜伟青.急性上消化道穿孔的临床诊疗分析[J/OL].临床医药文献电子杂志,2018,5(14):31-32.
[11]彭华彬,章琳,孙海光.腹腔镜穿孔修补术治疗上消化道溃疡穿孔的可行性分析[J].首都食品与医药,2018,25(6):9-10.
[12]邓锋,胡石甫,郝媛媛,等.腹腔镜及开腹手术治疗上消化道穿孔的疗效评估[J].临床医学,2017,37(4):17-19.
[13]杨文斌.上消化道穿孔腹腔镜修补术与开腹修补术术后胃肠动力恢复的对比研究[J].中国处方药,2017,15(1):117-118.
[14]刘永健,徐东楚,于海文.腹腔镜治疗上消化道穿孔临床体会[J/OL].临床医药文献电子杂志,2017,4(73):14276-14277.
[15]朱学魁.腹腔镜上消化道穿孔修补术的临床效果和价值分析[J].世界最新医学信息文摘,2018,18(8):35-41.
[16]吴锡川,王康,庞明辉,等.腹腔镜联合胃镜治疗上消化道穿孔的临床研究[J].四川医学,2016,37(9):1000-1001.
[17]许宇彪,李碧锦,何二松,等.腹腔镜与开腹修补术治疗老年上消化道穿孔的对照研究[J].中国医学创新,2016,13(32):28-31.
[18]严希宽,温新如,范利.腹腔镜与开腹手术治疗上消化道穿孔的临床效果观察[J].基层医学论坛,2016,20(31):4394-4396.
[19]康昆波.腹腔镜在上消化道穿孔中的应用[J].中国医疗器械信息,2016,22(16):56-57.
[2]刘沛华.腹腔镜上消化道穿孔修补术治疗上消化道穿孔的疗效[J].实用临床医学,2015,16(2):46-47.
[3]闫凌.腹腔镜上消化道穿孔修补术治疗39例上消化道穿孔的效果探讨[J].中国实用医药,2016,11(11):71-72.
[4]翟长元.腹腔镜上消化道穿孔修补术32例临床治疗分析[J].心理医生,2016,22(25):110-111.
[5]王亮,折占飞,乔宇,等.腹腔镜联合胆道镜经胆囊管探查治疗胆囊结石合并胆总管结石[J].中国微创外科杂志,2017,17(2):189-192.
[6]朱金理,汪东树,潘书鸿.腹腔镜联合胆道镜治疗胆囊胆总管结石与开腹手术疗效比较的回顾性研究[J].肝胆外科杂志,2016,24(3):200-203.
[7]杨如高,连立之,张佳文.三种不同手术方式治疗胆囊结石合并胆总管结石的疗效及安全性分析[J].肝胆外科杂志,2017,25(1):30-33.
[8]刘如金.48例上消化道穿孔临床诊治分析[J].世界最新医学信息文摘,2018,18(13):81.
[9]尹洪泉,庞宏欣,刘军.腹腔镜支持手术与开腹手术治疗上消化道穿孔的并发症发生及预后对比[J].四川生理科学杂志,2018,40(2):1-6.
[10]赵杰,姜伟青.急性上消化道穿孔的临床诊疗分析[J/OL].临床医药文献电子杂志,2018,5(14):31-32.
[11]彭华彬,章琳,孙海光.腹腔镜穿孔修补术治疗上消化道溃疡穿孔的可行性分析[J].首都食品与医药,2018,25(6):9-10.
[12]邓锋,胡石甫,郝媛媛,等.腹腔镜及开腹手术治疗上消化道穿孔的疗效评估[J].临床医学,2017,37(4):17-19.
[13]杨文斌.上消化道穿孔腹腔镜修补术与开腹修补术术后胃肠动力恢复的对比研究[J].中国处方药,2017,15(1):117-118.
[14]刘永健,徐东楚,于海文.腹腔镜治疗上消化道穿孔临床体会[J/OL].临床医药文献电子杂志,2017,4(73):14276-14277.
[15]朱学魁.腹腔镜上消化道穿孔修补术的临床效果和价值分析[J].世界最新医学信息文摘,2018,18(8):35-41.
[16]吴锡川,王康,庞明辉,等.腹腔镜联合胃镜治疗上消化道穿孔的临床研究[J].四川医学,2016,37(9):1000-1001.
[17]许宇彪,李碧锦,何二松,等.腹腔镜与开腹修补术治疗老年上消化道穿孔的对照研究[J].中国医学创新,2016,13(32):28-31.
[18]严希宽,温新如,范利.腹腔镜与开腹手术治疗上消化道穿孔的临床效果观察[J].基层医学论坛,2016,20(31):4394-4396.
[19]康昆波.腹腔镜在上消化道穿孔中的应用[J].中国医疗器械信息,2016,22(16):56-57.
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