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中华普外科手术学杂志(电子版) ›› 2018, Vol. 12 ›› Issue (03) : 238 -241. doi: 10.3877/cma.j.issn.1674-3946.2018.03.018

所属专题: 文献

论著

胃十二指肠溃疡患者的微创手术修补效果研究
杜刚1,(), 杨林2, 康乐斯基3, 唐正勇1   
  1. 1. 624000 四川阿坝州人民医院外二科
    2. 624000 四川阿坝州人民医院内镜室
    3. 624000 四川阿坝州人民医院消化内科
  • 收稿日期:2018-02-25 出版日期:2018-06-26
  • 通信作者: 杜刚

Study on Minimally Invasive Surgical Repair of Patients with gastroduodenal Ulcer

Gang Du1,(), Lin Yang2, Le-si-ji Kang3, Zhengyong Tang1   

  1. 1. Surgery Dept, Aba Prefecture People’s Hospital, Aba Sichuan, 624000
    2. Endoscopy Room, Aba Prefecture People’s Hospital, Aba Sichuan, 624000
    3. Medical Gastroenterology, Aba Prefecture People’s Hospital, Aba Sichuan, 624000
  • Received:2018-02-25 Published:2018-06-26
  • Corresponding author: Gang Du
  • About author:
    Corresponding author: Du Gang, Email:
  • Supported by:
    Sichuan Wei Jian Committee funded research projects(160342)
引用本文:

杜刚, 杨林, 康乐斯基, 唐正勇. 胃十二指肠溃疡患者的微创手术修补效果研究[J]. 中华普外科手术学杂志(电子版), 2018, 12(03): 238-241.

Gang Du, Lin Yang, Le-si-ji Kang, Zhengyong Tang. Study on Minimally Invasive Surgical Repair of Patients with gastroduodenal Ulcer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2018, 12(03): 238-241.

目的

探讨胃十二指肠溃疡患者的微创手术修补效果。

方法

前瞻性研究2014年3月至2017年3月106例胃十二指肠溃疡患者不同手术方法效果,根据数字表法随机将患者分为开腹组和腹腔镜组,每组53例。采用SPSS 15.0软件进行统计分析,两组患者术中术后各项指标及疼痛评分的比较采用(±s)表示,组间比较采用独立t检验;两组的近远期并发症发生率、复发率比较采用χ2检验,P<0.05表示差异有统计学意义。

结果

腹腔镜组患者的手术时间、术中出血量、术后1天、术后3天的疼痛评分及术中芬太尼用量均低于开腹组,差异具有统计学意义;腹腔镜组患者的术后近期并发症发生率3.8%低于开腹组18.9%(χ2=5.957, P=0.015),术后1年远期并发症发生率3.8%也低于开腹组24.5%(χ2=9.308, P=0.002),差异均具有统计学意义;开腹组1年内胃十二指肠溃疡复发7例,复发率为13.2%,腹腔镜组1年内胃十二指肠溃疡复发1例,复发率1.9%,两组患者的胃十二指肠溃疡复发率的差异具有统计学意义(χ2=4.821, P=0.028)。

结论

微创腹腔镜疗法应用于胃十二指肠溃疡患者的治疗可以缩短手术时间,减少术中出血量,降低术后和远期并发症,减少术后疼痛,值得临床推广。

Objective

To investigate the effect of minimally invasive surgery on patients with gastroduodenal ulcer.

Methods

106 patients with gastroduodenal ulcer from March 2014 to March 2017 were prospectively studied. Patients were randomly divided into open group and laparoscopic group according to digital table method, each 53 cases. SPSS 15.0 software was used for statistical analysis. The comparison of the intraoperative and postoperative data and pain scores between the two groups was indicated by (±s), comparedwith independent t test, the χ2 test was used to compare the incidence of short-term and long-term complications and recurrence rates between the two groups. P<0.05 indicated statistically significant difference.

Result

The operative time, intraoperative blood loss, postoperative 1 day and postoperative 3 days pain scores and intraoperative fentanyl dose in the laparoscopic group were lower than those in the open group, the difference was statistically significant; The incidence of postoperative short-term complications in the laparoscopic group was 3.8% which was lower than in the open group 18.9% (χ2=5.957, P=0.015), the incidence of long-term complications after one year was 3.8%, which was also lower than that of open group (24.5%) (χ2=9.308, P=0.002), the differences were statistically significant. In the open group, there were 7 cases of recurrent gastroduodenal ulcer with a recurrence rate of 13.2%, in the laparoscopic group, there was one recurrence of gastroduodenal ulcer within one year, with a recurrence rate of 1.9%, the difference in the recurrence rate of gastroduodenal ulcer between the two groups was statistically significant (χ2=4.821, P=0.028).

Conclusion

The application of minimally invasive laparoscopic therapy in patients with gastroduodenal ulcer can shorten the operation time, reduce the amount of intraoperative blood loss, reduce postoperative and long- term complications, reduce postoperative pain, which deserves clinical promotion.

表1 106例胃十二指肠溃疡患者不同手术方法两组患者一般资料比较(±s,例)
表2 106例胃十二指肠溃疡患者不同手术方法两组患者手术相关指标比较(±s)
表3 106例胃十二指肠溃疡患者不同手术方法两组患者术后并发症的比较(例)
表4 106例胃十二指肠溃疡患者不同手术方法两组患者疼痛评分的比较(±s)
表5 106例胃十二指肠溃疡患者不同手术方法两组患者术后恢复情况的比较(±s)
表6 106例胃十二指肠溃疡患者不同手术方法两组患者远期并发症发生率(例)
[1]
张晓雨,杨金云,平洪,等.经腹腔镜胃十二指肠溃疡穿孔修补术34例临床分析[J].中华实用诊断与治疗杂志,2014,28(2):183-184.
[2]
孟松,李超,姚立彬,等. 腹腔镜下修补术治疗十二指肠溃疡急性穿孔的临床疗效与安全性分析[J/CD]. 中华普外科手术学杂志(电子版), 2017, 11(1):49-51.
[3]
Guadagni S, Cengeli I, Galatioto C, et al. Laparoscopic repair of perforated peptic ulcer: single-center results[J]. Surgical endoscopy, 2014, 28(8):2302-2308.
[4]
徐文华. 两种方法治疗胃,十二指肠溃疡穿孔手术临床疗效观察[J]. 现代诊断与治疗,2014, 25(3):612-612.
[5]
王永,苏鑫.腹腔镜胃十二指肠溃疡穿孔修补术降低患者应激反应临床分析[J/CD].中华普外科手术学杂志(电子版),2016,10(1):54-56.
[6]
廖梓群,陈维荣,陈喜贵,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.
[7]
洪军波,汪安江,朱宏涛,等.272例残胃溃疡临床特征分析[J].中华消化杂志,2014,34(9):593-596.
[8]
黄俏碧. 腹腔镜与开腹十二指肠溃疡穿孔修补术疗效比较[J]. 中国处方药,2016, 14(10):135-136.
[9]
Teoh AY, Chiu PW, Kok AS, et al. The selective use of laparoscopic repair is safe in high-risk patients suffering from perforated peptic ulcer[J]. World journal of surgery, 2015, 39(3):740-745.
[10]
高德康,危少华,刘洋,等.腹腔镜胆总管探查术罕见并发十二指肠溃疡大出血五例分析[J].中华普通外科杂志,2014,29(5):393-394.
[11]
杨斌,施益九,严志龙.完全腹腔镜下十二指肠溃疡旷置术2例[J].中华胃肠外科杂志,2017,20(1):107-108.
[12]
Nagai E, Nakata K, Ohuchida K, et al. Laparoscopic total gastrectomy for remnant gastric cancer: feasibility study[J]. Surgical endoscopy, 2014, 28(1):289-296.
[13]
孟松,李超,姚立彬,等.腹腔镜下修补术治疗十二指肠溃疡急性穿孔的临床疗效与安全性分析[J/CD].中华普外科手术学杂志(电子版),2017,11(1):49-51.
[14]
Muller MK, Wrann S, Widmer J, et al. Perforated Peptic Ulcer Repair: Factors Predicting Conversion in Laparoscopy and Postoperative Septic Complications[J]. World journal of surgery, 2016, 40(9):2186-2193.
[15]
Karydakis P, Semenov DI, Kyriakidis AV, et al. Laparoscopic Management of Perforated Peptic Ulcer: Simple Closure or Something More?[J]. Open Journal of Gastroenterology, 2016, 6(11):149-156.
[16]
Ribeiro-Parenti L, Arapis K, Chosidow D, et al. Comparison of marginal ulcer rates between antecolic and retrocolic laparoscopic Roux-en-Y gastric bypass[J]. Obesity surgery, 2015, 25(2):215-221.
[17]
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/CD].中华临床医师杂志(电子版),2016,10(18):2705-2709.
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