腹腔镜胃穿孔修补术与开腹手术后患者康复情况的临床比较研究

摘要

目的：为了进一步比较和研究腹腔镜胃穿孔修补术与开腹手术后患者在康复效果上的差异，从而为临床手术方式的选择以及相关研究提供借鉴。方法本次研究所选取的研究对象均为2009年12月~2013年1月我院收治的胃肠穿孔患者，全部研究对象共计130例。分成腹腔镜手术组和开腹手术组，每组患者均为65例。分别采用腹腔镜胃穿孔修补术与开腹手术实施治疗。观察并比较两组研究对象实施不同临床手术治疗方法后的血清胃泌素水平、肠鸣音恢复时间、肛门排气时间、平均住院时间和手术平均时间。结果①在血清胃泌素水平上，手术后1 h、24 h、48 h和72 h的指标水平组间比较，腹腔镜手术组患者的指标水平均优于开腹手术组，且组间数据差异均具有统计学意义(均P<0.05)；②在肠鸣音恢复时间、肛门排气时间、平均住院时间和手术平均时间等四项指标上，组间比较，腹腔镜手术组患者的指标水平均优于开腹手术组，且组间数据差异均具有统计学意义(均P<0.05)。结论在临床针对胃肠穿孔患者实施治疗的实践过程中，采用腹腔镜胃穿孔修补术与开腹手术相比较，相关患者的术后康复情况更好，采用腹腔镜胃穿孔修补术是治疗胃肠穿孔的理想选择。%Objective To compare and study the differences of postoperative rehabilitation situation of patients with laparoscopic repair of gastric perforation and open operation ,in order to provide referencefor the selection of clinical operation types and related study. Methods The patients with gastric perforation in our hospital from December 2009 to January 2013 were the study object,and they were divided into laparoscopic operation group and open operation group,each group included 65 cases, and they were respectively treated with laparoscopic repair of gastric perforation and open operation .Then the serum gastrin levels,recovery time of bowel sound, anal exhaust time,average hospitalization time and average operation time of two groups with dif erent clinical operation method were observe and compared.Results ①The serum gastrin levels of laparoscopic operation group at 1h,24h,48h and 72h after the operation were al bet er than those of open operation group,the results of two groups had significant differences (al P<0.05);②The recovery time of bowel sound, anal exhaust time,average hospitalization time and average operation time of laparoscopic operation group were al bet er than those of open operation group,the results of two groups had significant dif erences (al P<0.05).Conclusion The postoperative rehabilitation situation of patients with laparoscopic repair of gastric perforation are relatively better thyan that of open operation during the therapy practice of gastric-intestinal perforation,the laparoscopic repair of gastric perforation are the ideal choice of gastric-intestinal perforation.