开腹与腹腔镜修补术治疗老年上消化道穿孔手术并发症及预后的对比分析

摘要

Objective:To compare the complication and prognosis between open and laparoscopic repair of perforation of upper digestive tract in elderly patients.Methods:Clinical data of 72 elderly patients who had received surgical repair of perforation of upper digestive tract from Jan.2005 to Dec.2012 were analyzed retrospectively.34 patients received open repair and 38 patients received laparoscopic repair.Results:Sixty-nine cases were cured and 3 died.There were significant differences in post-operative incision infection (14.7％ vs.0,P ＜ 0.05) and pulmonary infection (26.5％ vs.7.9％,P ＜ 0.05) between open and laparoscopic groups.There was no statistical difference in post-operative intraperitoneal infection (14.7％ vs.5.3％,P ＞ 0.05) and mortality (5.9％ vs.2.6％,P ＞ 0.05) between the two groups.Conclusions:Laparoscopic repair of perforation of upper digestive tract can be safely carried out in elderly patients.Reduction of postoperative complications is the embodiment of the advantages of minimal invasion.%目的:探讨开腹与腹腔镜修补术治疗老年患者上消化道穿孔的手术并发症及预后.方法:回顾分析2005年1月至2012年12月手术治疗72例上消化道穿孔老年患者的临床资料,其中34例行开腹修补术(开腹组),38例行腹腔镜修补术(腹腔镜组).结果:69例治愈,3例死亡.两组患者死亡率及腹腔感染率差异无统计学意义(P＞0.05)；腹腔镜组切口感染率、肺部感染率明显降低(P＜0.05).结论:腹腔镜穿孔修补术治疗老年患者上消化道穿孔安全可行,术后并发症少,微创优势明显.