腹腔镜胃穿孔修补术的综合疗效观察(1)
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[摘要] 目的 探讨腹腔镜胃穿孔修补术的综合疗效。 方法 选取2008年1月～2011年6月于本院进行治疗的68例胃穿孔患者为研究对象，将其随机分为对照组34例和观察组34例，对照组采用开腹修补术进行治疗，观察组采用腹腔镜修补术进行治疗，后将两组患者的住院时间、排气时间、肠鸣音恢复时间、并发症发生率及术前、术后1、3 d的血清CRP、IL-6及TNF-α水平进行统计及比较。 结果 观察组的住院时间[(6.7±1.2) d]、排气时间[(22.4±4.9) h]、肠鸣音恢复时间[(20.6±3.6) h]、并发症发生率(2.94%)等方面均优于对照组，而术后1、3 d的血清CRP、IL-6及TNF-α水平均低于对照组，P均 < 0.05，差异均有统计学意义。 结论 腹腔镜胃穿孔修补术的临床疗效较佳，且对患者的手术性创伤更小，患者的应激反应也更小。
[关键词] 腹腔镜；胃穿孔修补术；综合疗效；观察
[中图分类号] R656.6+1 [文献标识码] A [文章编号] 1674-4721(2012)02(b)-0046-02
Observation on the comprehensive therapeutic effect of laparoscopic repair of perforated peptic ulcer
WU Shiying
Hetang Town Health Center of Gaozhou City in Guangdong Province, Gaozhou 525261, China
[Abstract] Objective To study the comprehensive therapeutic effect of laparoscopic repair of perforated peptic ulcer. Methods Sixty eight patients with gastric perforation in our hospital from January 2008 to June 2011 were selected as research object, and they were randomly divided into control group 34 cases and observation group 34 cases，then the hospitalization time, exhaust time, recovery time of intestinal sound, incidence of adverse reactions and serum CRP, IL-6, TNF-α before and after the surgery at first and third day of two groups were analyzed and compared. Results The hospitalization time [(6.7±1.2) d], exhaust time [(22.4±4.9) h], recovery time of intestinal sound [(20.6±3.6) h], incidence of adverse reactions (2.94%) were all better than those of control group, the serum CRP, IL-6 and TNF-α of observation group after the surgery at first and third day were all better than those of control group, all P < 0.05, there were all significant differences. Conclusion The comprehensive therapeutic effect of laparoscopic repair of perforated peptic ulcer is better, and the surgical induced trauma is smaller, stress response of patients is smaller too.
[Key words] Laparoscopy; Repair of perforated peptic ulcer; Comprehensive therapeutic effect; Observation
近年来随着洧川术式的不断发展和成熟完善，腹腔镜术式在临床中的应用率也越来越高，其在多个科室中的效果已经得到肯定。胃穿孔修补术中应用腹腔镜进行微创术式的进行也逐步在临床中进行了应用[1]，但是对于其综合疗效还存在一定的争议[2]。本文中笔者即就腹腔镜胃穿孔修补术的综合疗效进行观察，现将结果总结报道如下： ......
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