2种不同手术方法用于治疗急性胃穿孔的效果观察与系统评价

摘要

Objective:This paper is to systematically evaluate the efficacy of two different surgical methods clinically used on the recovery of gastrointestinal functions of patients with acute gastric perforation in clinical treatment .Meth‐ods:Sixty patients with acute gastric perforation admitted by the In‐patient Department from January 1 ,2013 to De‐cember 1 ,2014 were selected as research subjects ,all of whom were treated with surgeries ,who were divided into the research group (30 cases ,subject to laparoscopic gastrorrhaphy) and the control group (30 cases ,subject to laparoto‐my gastrorrhaphy ) according to different operation methods ,details of clinical treatment ,gastric ulcer recovery and complications ,the level of serum and gastrin as well as the recovery of gastrointestinal function of patients in two groups were compared and analyzed .Results:The recovery of patients in the research group in indicators including the anus exhaust time ,recovery time of bowel sound ,hospital stay ,serum levels of serum gastrin were better ,and the in‐ter‐group statistics t test satisfied P<0 .05 ,the differences were obvious .Total recovery rate of patients with gastric ulcer (96 .67% ) in the research group were better than that of patients in the control group (86 .67% ) ,postoperative complications rate (6 .67% ) of patients in the research group were lower than that of patients in the control group (16.67% ) ,the inter‐group statistics χ2 test satisfied P<0 .05 ,and the differences were obvious .Conclusion:Laparo‐scopic gastrorrhaphy delivers more distinct efficacy in the treatment of clinically acute gastric perforation when com‐pared to that of laparotomy gastrorrhaphy ,and effectively recover gastrointestinal functions of patients ,generating the complication rate and high safety ,it is suggested to be preferentially selected and used in clinical services .%目的：系统评价2种不同手术方式治疗对急性胃穿孔患者胃肠功能恢复的效果。方法：选定2013年1月1日－2014年12月1日住院部收治的60例急性胃穿孔患者作为研究对象，均接受手术治疗，根据手术方式的不同分为研究组（30例，腹腔镜下胃修补术）和对照组（30例，开腹胃修补术），对比分析两组患者的临床治疗情况、胃溃疡恢复和并发症、血清胃泌素水平及胃肠功能的恢复。结果：研究组在肛门排气时间、肠鸣音恢复时间、住院时间以及血清胃泌素水平等指标上恢复较对照组良好，组间数据经统计学 t检验，P＜0．05，差异明显。研究组胃溃疡总恢复率（96．67％）高于对照组（86．67％），术后并发症率（6．67％）均低于对照组（16．67％），组间经统计学χ2检验，P＜0．05，差异明显。结论：腹腔镜下胃修补术在急性胃穿孔的治疗中较开腹胃修补术疗效显著，有效恢复患者胃肠功能，且并发症率低，安全性高，建议在临床中优先选择使用。