传统开腹手术及腹腔镜手术治疗老年上消化道穿孔的临床对比研究(1)
【摘要】 目的：对比开腹手术及腹腔镜手术治疗老年上消化道穿孔的临床效果。方法：选取2017年2月-2018年1月来本院消化内科接受治疗的老年上消化道穿孔患者62例作为研究对象，根据不同的治疗方式将其分为对照组和观察组，各31例。对照组采用传统的开腹手术治疗，观察组采用腹腔镜手术治疗，观察对比两组的手术指标、术后并发症发生情况以及对治疗的满意程度。结果：观察组手术时间明显长于对照组，切口长度明显短于对照组，术中出血量明显少于对照组，差异均有统计学意义(P<0.05)。观察组术后镇痛及住院时间均明显短于对照组，术后肛门排气时间明显早于对照组，差异均有统计学意义(P<0.05)。观察组术后并发症发生率明显低于对照组，差异有统计学意义(字2=8.093，P=0.025)。观察组对治疗的总满意度为96.77%明显高于对照组的54.84%，差异有统计学意义(字2=7.664，P=0.033)。结论：对老年上消化道穿孔患者采用腹腔镜手术治疗可以明显地缩短切口长度、住院以及术后镇痛时间，加快患者的肛门排气速度，减少在手术中的出血量，同时还可以降低患者在术后并发症的發生率，因此在临床上应大力推广。
【关键词】 开腹手术; 腹腔镜; 老年; 上消化道穿孔
【Abstract】 Objective：To compare the clinical effect of laparotomy and laparoscopic surgery in the treatment of elderly patients with upper gastrointestinal tract perforation.Method：A total of 62 elderly patients with upper gastrointestinal tract perforation treated in the Gastrointestinal Medicine Department of our hospital from February 2017 to January 2018 were selected as the research objects.According to different treatment methods，they were divided into control group and observation group，31 cases in each group.The control group was treated with traditional laparotomy，the observation group was treated with laparoscopic surgery.The surgical indicators，occurrence of postoperative complications and satisfaction with treatment between the two groups were observed and compared.Result：The operation time of the observation group was significantly longer than that of the control group，the incision length was significantly shorter than that of the control group，the amount of intraoperative bleeding was significantly less than that of the control group，the differences were statistically significant (P<0.05).The time of postoperative analgesia and hospitalization in the observation group were significantly shorter than those in the control group，the time of postoperative anal exhaust was significantly earlier than that in the control group，the differences were statistically significant (P<0.05).The incidence of postoperative complications in the observation group was significantly lower than that in the control group，the difference was statistically significant (字2=8.093，P=0.025).The total satisfaction degree with treatment of the observation group was 96.77%，which was significantly higher than 54.84% of the control group，the difference was statistically significant (字2=7.664，P=0.033).Conclusion：Laparoscopic surgery in the treatment of elderly patients with upper gastrointestinal tract perforation can significantly shorten the length of incision，hospitalization and postoperative analgesia time，accelerate the speed of anal exhaust，reduce the amount of intraoperative bleeding and also reduce the incidence of postoperative complications at the same time.Therefore，it should be vigorously promoted in clinical practice., http://www.100md.com(李涛)
【关键词】 开腹手术; 腹腔镜; 老年; 上消化道穿孔
【Abstract】 Objective：To compare the clinical effect of laparotomy and laparoscopic surgery in the treatment of elderly patients with upper gastrointestinal tract perforation.Method：A total of 62 elderly patients with upper gastrointestinal tract perforation treated in the Gastrointestinal Medicine Department of our hospital from February 2017 to January 2018 were selected as the research objects.According to different treatment methods，they were divided into control group and observation group，31 cases in each group.The control group was treated with traditional laparotomy，the observation group was treated with laparoscopic surgery.The surgical indicators，occurrence of postoperative complications and satisfaction with treatment between the two groups were observed and compared.Result：The operation time of the observation group was significantly longer than that of the control group，the incision length was significantly shorter than that of the control group，the amount of intraoperative bleeding was significantly less than that of the control group，the differences were statistically significant (P<0.05).The time of postoperative analgesia and hospitalization in the observation group were significantly shorter than those in the control group，the time of postoperative anal exhaust was significantly earlier than that in the control group，the differences were statistically significant (P<0.05).The incidence of postoperative complications in the observation group was significantly lower than that in the control group，the difference was statistically significant (字2=8.093，P=0.025).The total satisfaction degree with treatment of the observation group was 96.77%，which was significantly higher than 54.84% of the control group，the difference was statistically significant (字2=7.664，P=0.033).Conclusion：Laparoscopic surgery in the treatment of elderly patients with upper gastrointestinal tract perforation can significantly shorten the length of incision，hospitalization and postoperative analgesia time，accelerate the speed of anal exhaust，reduce the amount of intraoperative bleeding and also reduce the incidence of postoperative complications at the same time.Therefore，it should be vigorously promoted in clinical practice., http://www.100md.com(李涛)