可吸收线在腹腔镜胃十二指肠溃疡穿孔修补术中的临床应用
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摘要
目的:探讨可吸收线应用于腹腔镜胃十二指肠溃疡穿孔修补术的临床效果。方法:选择2016年6月至2017年12月收治的80例胃十二指肠溃疡穿孔患者作为研究对象,分为对照组与实验组,每组40例。对照组采用普通丝线行腹腔镜胃十二指肠溃疡穿孔修补术,实验组采用可吸收线行腹腔镜胃十二指肠溃疡穿孔修补术,比较两组术中、术后情况。结果:两组缝合时间、手术时间、术中出血量、术后疼痛程度、术后恢复活动时间、术后住院时间、术后镇痛药需求及并发症发生率差异均无统计学意义(P>0.05)。术后复查胃镜示,实验组1例溃疡未愈合,对照组8例溃疡未愈合,继续予以药物治疗后溃疡均愈合;实验组溃疡愈合情况优于对照组,差异有统计学意义(P<0.05)。结论:采用可吸收线行腹腔镜胃十二指肠溃疡穿孔修补术有助于促进溃疡早期愈合,值得临床应用。
Objective: To discuss the clinical effect of absorbable suture in laparoscopic repair of gastroduodenal ulcer perforation.Methods: A total of 80 patients with perforation of gastroduodenal ulcer from Jun.2016 to Dec.2017 were selected as the study objects.They were divided into control group and experimental group with 40 cases in each group.Patients in the control group underwent laparoscopic repair of gastroduodenal ulcer perforation with ordinary silk thread,and patients in the experimental group underwent laparoscopic repair of gastroduodenal ulcer perforation with absorbable suture,the intraoperative and postoperative conditions were compared between the two groups.Results: There were no significant differences in suture time,operative time,intraoperative blood loss,postoperative pain degree,ambulation time,postoperative hospital stay,postoperative analgesic requirement and complication incidence between experimental group and control group( P>0.05).Postoperative gastroscopy revealed that 1 case of ulcer in the experimental group and 8 cases of ulcer in the control group were not healed,and all the ulcers healed after medication,with significant difference( P < 0.05).Conclusions: The use of absorbable suture in laparoscopic repair of perforated gastric and duodenal ulcer can help to promote the early healing of ulcer,and deserves to be recommended in the clinical application.
Objective: To discuss the clinical effect of absorbable suture in laparoscopic repair of gastroduodenal ulcer perforation.Methods: A total of 80 patients with perforation of gastroduodenal ulcer from Jun.2016 to Dec.2017 were selected as the study objects.They were divided into control group and experimental group with 40 cases in each group.Patients in the control group underwent laparoscopic repair of gastroduodenal ulcer perforation with ordinary silk thread,and patients in the experimental group underwent laparoscopic repair of gastroduodenal ulcer perforation with absorbable suture,the intraoperative and postoperative conditions were compared between the two groups.Results: There were no significant differences in suture time,operative time,intraoperative blood loss,postoperative pain degree,ambulation time,postoperative hospital stay,postoperative analgesic requirement and complication incidence between experimental group and control group( P>0.05).Postoperative gastroscopy revealed that 1 case of ulcer in the experimental group and 8 cases of ulcer in the control group were not healed,and all the ulcers healed after medication,with significant difference( P < 0.05).Conclusions: The use of absorbable suture in laparoscopic repair of perforated gastric and duodenal ulcer can help to promote the early healing of ulcer,and deserves to be recommended in the clinical application.
引文
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[10]周礼,庄文.腹腔镜消化性溃疡穿孔修补术中中转开腹的危险因素分析[J].中国普外基础与临床杂志,2017,24(2):195-200.
[11]陈双,周太成.组织缝合修补和补片修补的利弊再认识[J].中国实用外科杂志,2017,37(11):1227-1230.
[12]张国锦,李刚,周伟亚.外科手术切口组织愈合不良裂开原因探讨[J].中国现代医生,2015,53(23):41-43.
[13]廖梓群,陈维荣,陈喜责,等.倒刺缝线在腹腔镜胃十二指肠溃疡穿孔修补术中的应用[J/CD].中华普外科手术学杂志(电子版),2017,11(1):46-48.
[14]Kim TH,Park JH,Jeong SH,et al.Feasibility of a novel laparoscopic technique with unidirectional knotless barbed sutures for the primary closure of duodenal ulcer perforation[J].Surg Endosc,2018,32(8):3667-3674.
[2]张贤坤,刘宏斌,韩晓鹏,等.腹腔镜技术在老年胃十二指肠溃疡穿孔患者中的应用[J].腹腔镜外科杂志,2015,21(10):788-790.
[3]Bautista T,Shabbir A,Rao J,et al.Enterotomy closure using knotless and barbed suture in laparoscopic upper gastrointestinal surgeries[J].Surg Endosc,2016,30(4):1699-1703.
[4]王科,林春华,门昌平,等.双向倒刺可吸收线在后腹腔镜肾部分切除术中的应用[J].中华实验外科杂志,2012,29(12):2595-2596.
[5]Budzyński P,Pdziwiatr M,Grzesiak-Kuik A,et al.Changing patterns in the surgical treatment of perforated duodenal ulcer-single centre experience[J].Wideochir Inne Tech Maloinwazyjne,2015,10(3):430-436.
[6]《中华消化杂志》编委会.消化性溃疡诊断与治疗规范(2016年,西安)[S].中华消化杂志,2016,36(8):508-513.
[7]郑侃侃,廖付良,谢文彪.试谈消化性溃疡穿孔非手术治疗中的几个问题[J].国际外科学杂志,2015,42(10):649-651.
[8]钟锋,王金重,赖建生,等.腹腔镜与开腹胃十二指肠溃疡穿孔修补术的前瞻性随机对照研究[J].中国微创外科杂志,2014,14(9):782-785.
[9]尹清华,陈健,徐大勇,等.硬膜外麻醉下不同二氧化碳气腹压在腹腔镜消化性溃疡穿孔修补术中应用的前瞻性随机对照研究[J].中国微创外科杂志,2010,10(7):591-593.
[10]周礼,庄文.腹腔镜消化性溃疡穿孔修补术中中转开腹的危险因素分析[J].中国普外基础与临床杂志,2017,24(2):195-200.
[11]陈双,周太成.组织缝合修补和补片修补的利弊再认识[J].中国实用外科杂志,2017,37(11):1227-1230.
[12]张国锦,李刚,周伟亚.外科手术切口组织愈合不良裂开原因探讨[J].中国现代医生,2015,53(23):41-43.
[13]廖梓群,陈维荣,陈喜责,等.倒刺缝线在腹腔镜胃十二指肠溃疡穿孔修补术中的应用[J/CD].中华普外科手术学杂志(电子版),2017,11(1):46-48.
[14]Kim TH,Park JH,Jeong SH,et al.Feasibility of a novel laparoscopic technique with unidirectional knotless barbed sutures for the primary closure of duodenal ulcer perforation[J].Surg Endosc,2018,32(8):3667-3674.
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