胃穿孔采用腹腔镜修补术的治疗观察及临床评价
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摘要
目的探究胃穿孔采用腹腔镜修补术治疗的观察及临床评价。方法选取胃穿孔患者80例随机分为两组,对照组采取开腹修补术治疗,观察组采取腹腔镜修补术治疗,考察两组患者的手术指标情况、术后疼痛评分和并发症情况。结果在手术指标情况方面,两组患者的手术时间、引流管拔管时间差异无统计学意义(P> 0.05),观察组患者的术中出血量、肠鸣音恢复时间、肛门排气时间、住院时间低于对照组(P <0.05),在患者的术后疼痛方面,观察组患者术后第1、3、7天VAS评分均低于对照组(P <0.05);观察组有3例术后应用镇静剂,对照组有21例术后应用镇静剂,观察组镇静剂使用率低于对照组;在并发症发生情况方面,观察组患者的并发症发生率为5.00%,对照组患者的并发症发生率为20.00%,观察组患者的并发症发生率低于对照组,差异有统计学意义(P <0.05)。结论胃穿孔行腹腔镜修补术治疗的效果良好。
Objective To explore the observation and clinical evaluation of laparoscopic repair for gastric perforation. Methods 80 patients with gastric perforation were randomly divided into two groups. The control group was treated with open repair, and the observation group was treated with laparoscopic repair. The surgical indicators, postoperative pain scores and complications were compared between the two groups. Results There was no significant difference in operation time and drainage tube extubation time between the two groups(P > 0.05). The bleeding volume, bowel sounds recovery time, anal exhaust time and hospitalization time in the observation group were significantly lower than those in the control group(P < 0.05). The VAS scores of the patients in the observation group were significantly lower than those in the control group on the first, third and seventh days after operation(P < 0.05); 3 cases in the observation group were treated with sedatives after operation, 21 cases in the control group were treated with sedatives after operation; the use rate of sedatives in the observation group was lower than that in the control group; the incidence of complications in the observation group was 5.00%, and the control group was 20.00%. The incidence of complications in the observation group was significantly lower than that in the control group, the difference was statistically significant(P < 0.05). Conclusion Laparoscopic repair of gastric perforation is effective.
Objective To explore the observation and clinical evaluation of laparoscopic repair for gastric perforation. Methods 80 patients with gastric perforation were randomly divided into two groups. The control group was treated with open repair, and the observation group was treated with laparoscopic repair. The surgical indicators, postoperative pain scores and complications were compared between the two groups. Results There was no significant difference in operation time and drainage tube extubation time between the two groups(P > 0.05). The bleeding volume, bowel sounds recovery time, anal exhaust time and hospitalization time in the observation group were significantly lower than those in the control group(P < 0.05). The VAS scores of the patients in the observation group were significantly lower than those in the control group on the first, third and seventh days after operation(P < 0.05); 3 cases in the observation group were treated with sedatives after operation, 21 cases in the control group were treated with sedatives after operation; the use rate of sedatives in the observation group was lower than that in the control group; the incidence of complications in the observation group was 5.00%, and the control group was 20.00%. The incidence of complications in the observation group was significantly lower than that in the control group, the difference was statistically significant(P < 0.05). Conclusion Laparoscopic repair of gastric perforation is effective.
引文
[1]黄宇,吴克松,陈汉光.胃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分析[J].白求恩医学杂志,2014,12(5):425-427.
[2]何劲松,李利发,张井潇,等.国内腹腔镜与开腹修补术在良性胃穿孔患者中应用的Meta分析[J].川北医学院学报,2016,31(4):493-499.
[3]包川.胃穿孔采用腹腔镜与开放性修补术治疗的效果分析[J].医药前沿,2018,8(21):139-140.
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[6]江现强.腹腔镜修补术与开腹胃大部分切除术治疗急性胃穿孔的疗效对比[J].中国医药指南,2015,13(3):80-81.
[7]李金博.腹腔镜修补术与开腹修补术治疗胃穿孔术后胃肠动力恢复情况对比研究[J].中国继续医学教育,2017,9(18):130-132.
[8]杨河,胡军,陈立智等.腹腔镜修补术治疗胃穿孔的疗效及安全性[J].海南医学,2017,28(23):3915-3917.
[9]王争鸣.胃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].中国实用医刊,2014,41(4):63-64.
[10]於轶南,张启鹤,曲作君.采用腹腔镜修补术与开腹修补术治疗胃穿孔的效果比较[J].当代医药论丛,2015,13(13):191-192.
[11]何志刚,何永忠,孔凡东,等.腹腔镜下穿孔修补术治疗老年胃溃疡合并胃穿孔的效果分析[J].中华临床医师杂志,2016,10(18):2705-2708.
[12]侯花屏,冯江,刘新奇,等.腹腔镜下穿孔修补术治疗老年胃溃疡合并胃穿孔的临床观察[J].老年医学与保健,2017,23(6):502-504.
[2]何劲松,李利发,张井潇,等.国内腹腔镜与开腹修补术在良性胃穿孔患者中应用的Meta分析[J].川北医学院学报,2016,31(4):493-499.
[3]包川.胃穿孔采用腹腔镜与开放性修补术治疗的效果分析[J].医药前沿,2018,8(21):139-140.
[4]王晓斌,卜甲庆,刘俊.腹腔镜修补术治疗胃穿孔的效果探讨[J].当代医药论丛,2018,16(7):160-161.
[5]吴世乐,郭亚民,吴新民,等.胃穿孔腹腔镜修补术的手术方法及临床效果观察[J].中国现代普通外科进展,2017,20(4):306-308.
[6]江现强.腹腔镜修补术与开腹胃大部分切除术治疗急性胃穿孔的疗效对比[J].中国医药指南,2015,13(3):80-81.
[7]李金博.腹腔镜修补术与开腹修补术治疗胃穿孔术后胃肠动力恢复情况对比研究[J].中国继续医学教育,2017,9(18):130-132.
[8]杨河,胡军,陈立智等.腹腔镜修补术治疗胃穿孔的疗效及安全性[J].海南医学,2017,28(23):3915-3917.
[9]王争鸣.胃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].中国实用医刊,2014,41(4):63-64.
[10]於轶南,张启鹤,曲作君.采用腹腔镜修补术与开腹修补术治疗胃穿孔的效果比较[J].当代医药论丛,2015,13(13):191-192.
[11]何志刚,何永忠,孔凡东,等.腹腔镜下穿孔修补术治疗老年胃溃疡合并胃穿孔的效果分析[J].中华临床医师杂志,2016,10(18):2705-2708.
[12]侯花屏,冯江,刘新奇,等.腹腔镜下穿孔修补术治疗老年胃溃疡合并胃穿孔的临床观察[J].老年医学与保健,2017,23(6):502-504.