探讨腹腔镜下修补胃十二指肠溃疡穿孔的临床效果与安全性。

选取2013年5月至2016年9月对胃十二指肠溃疡穿孔患者110例进行前瞻性研究，根据手术术式不同采取随机数字法分为腹腔镜(A组悬吊式35例、B组气腹式35例)和开腹式(开腹组40例)；应用SPSS 20.0统计学软件进行处理，术中及术后相关指标、术后疼痛评分和抗生素使用时间以±s表示，采用独立t检验；术后并发症的发生率采用卡方检验，以P<0.05表示差异有统计学意义。

与开腹组相比，腹腔镜A组悬吊式和B组气腹式患者的出血量和术后疼痛评分显著降低，手术时间、肛门排气时间、胃肠减压时间、住院时间和抗生素使用时间均显著缩短；与B组气腹式相比，A组悬吊式患者的出血量和术后疼痛评分更低，手术时间、肛门排气时间、胃肠减压时间、住院时间和抗生素使用时间均明显缩短(P<0.05)；A组悬吊式患者术后并发症的发生率为3例(8.6%)，B组气腹式患者术后并发症的发生率为5例(14.3%)，开腹组为14例(35.0%)，显著高于A组和B组，差异具有统计学意义(P<0.05)。

悬吊式腹腔镜技术修补胃十二指肠溃疡穿孔的临床效果较好，且安全性高，具有临床应用价值。

To investigate the clinical efficacy and safety of laparoscopic repair of perforation of gastroduodenal ulcer.

From May 2013 to September 2016, a prospective study was conducted in our hospital, 110 cases with perforation of gastroduodenal ulcer were collected. according to the random numbers methods, they were divided into laparoscope (35 cases by suspension type in A group and 35 cases by pneumoperitoneum type in B group) and open type (40 cases in open group), open group was given open surgery, laparoscope A group was given suspension type, laparoscope B group was given pneumoperitoneum type. Statistical analysis was performed by using SPSS 20.0 software, intraoperative and postoperative relevant indicators, the postoperative pain scores and time of antibiotic usage were presented as ±s and examined by using t test; the incidence of complication was presented as [n(%)] and examined by chi square test. A P value of <0.05 was considered as significant difference.

Compared with the open surgery group, the blood loss and postoperative pain scores of laparoscope A group with suspension type and B group with pneumoperitoneum type was significantly decreased, operation time, anus exhausting time, gastrointestinal decompression time, hospitalization time and antibiotic usage time were also significantly shorten; Compared with the laparoscope B group with pneumoperitoneum type, the blood loss and postoperative pain scores of laparoscope A group with suspension type were significantly decreased, operation time, anus exhausting time, gastrointestinal decompression time, hospitalization time and antibiotic usage time both significantly shorten (P<0.05); The total incidence of complications after operation of the laparoscope A group with suspension type was 3 cases (8.6%), the total incidence of complications after operation of laparoscope B group with pneumoperitoneum type was 5 cases (14.3%), the open surgery group was 14 cases (35.0%), which was significantly higher than that in the A and B group, the difference was statistically significant (P<0.05).

Laparoscope with suspension type in repair of perforation of gastroduodenal ulcer has good clinical efficacy, and security is high, which is worthy in clinical application.