目的 观察腹腔镜手术和传统开腹手术治疗消化性溃疡穿孔的临床疗效。方法 回顾性分析2014年1月—2017年12月采用腹腔镜修补术治疗20例消化性溃疡穿孔患者(观察组)的临床资料,并以同期采用开腹修补术治疗的20例消化性溃疡穿孔患者作对照(对照组);比较两组患者的手术指标、术后恢复、术后并发症及应激反应指标。 结果 观察组患者术后肛门排气、下床活动、住院时间,术后止痛药使用及术后疼痛评分均显著优于对照组(P<0.05);手术时间与对照组比较,差异无统计学意义(P>0.05);术后24 h和48 h CRP、WBC和PCT均低于对照组(P<0.05);术后并发症发生率亦低于对照组(5%对20%;χ²=4.11,P<0.05)。结论 腹腔镜修补术治疗消化性溃疡穿孔,患者恢复快,并发症和应激反应少,有较高的临床应用价值。

Objective To observe the clinical effects of laparoscopic surgery and traditional laparotomy on peptic ulcer perforation.Methods Patients with peptic ulcer perforation who received laparoscopic surgery (n=20, observation group) and who received open surgery (n=20, control group) from January 2014 to December 2017 were retrospectively analyzed.The surgical indices, recovery conditions, postoperative complications, and stress response were compared between the two groups.Results The postoperative exsufflation time,leaving bed time, hospital stays,use of painkillers, and pain scores of the observation group were significantly better than those of the control group (P<0.05).Although the operation time of the observation group was longer, no difference between the two groups was observed (P>0.05).CRP, WBC, and PCT at 24 h and 48 h postoperation of the observation group were significantly lower than those of the control group (P<0.05).The postoperative complication rate of the observation group was also significantly lower than that of the control group (5% vs.20%,χ²=4.11,P<0.05).Conclusion Laparoscopic surgery for peptic ulcer perforation shows good clinical effects, with less recovery time,complications, and stress response.