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中国人民解放军总医院老年心血管病研究所
中国科技出版传媒股份有限公司
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中华老年多器官疾病杂志编辑委员会
100853, 北京市复兴路28号
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E-mail: zhlndqg@mode301.cn
创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
友情链接
向桂华,黄建华,武正陆,陈爱军.腹腔镜修补术治疗老年十二指肠溃疡合并穿孔的疗效分析[J].中华老年多器官疾病杂志,2018,17(2):124~127
腹腔镜修补术治疗老年十二指肠溃疡合并穿孔的疗效分析
Efficacy of laparoscopic repair for duodenal ulcer complicated with perforation in the elderly
投稿时间:2017-09-28  修订日期:2017-11-12
DOI:10.11915/j.issn.1671-5403.2018.02.027
中文关键词:  腹腔镜;老年人;十二指肠溃疡;并发症
英文关键词:laparoscopy; aged; duodenal ulcer; complications
基金项目:
作者单位E-mail
向桂华 秭归县中医院普外科,宜昌 443600 xiangguihuaxg@163.com 
黄建华 秭归县中医院普外科,宜昌 443600  
武正陆 秭归县中医院普外科,宜昌 443600  
陈爱军 宜昌市中心人民医院胃肠外科,宜昌 443003  
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中文摘要:
      目的 探讨腹腔镜与开腹修补术对老年十二指肠溃疡合并穿孔(DUP)患者的疗效。方法 选取2014年3月至2017年3月秭归县中医医院普外科收治的老年DUP患者100例,依据治疗方法分为腹腔镜组和开腹组,每组50例。开腹组给予开腹修补术治疗,腹腔镜组给予腹腔镜修补术治疗,比较两组疗效、并发症和胃动素水平。采用SPSS 22.0软件进行数据处理。依据数据类型,组间比较分别采用t检验和χ2检验。结果 腹腔镜组下床时间[(28.87±3.07) vs(38.02±4.22)h]、住院时间[(3.69±0.82) vs(5.75±1.03)d]、肛门排气时间[(15.08±1.63) vs(27.36±2.86)h]、肠鸣音恢复时间[(64.58±6.62) vs(81.46±8.36)h]、术中出血量[(52.45±5.27) vs(76.74±8.04)ml]、并发症发生率(10.00% vs 28.00%)均显著低于开腹组(P<0.05)。腹腔镜组术后1 d[(182.43±19.52) vs(233.59±25.47)ng/L]和2 d[(156.37±16.24) vs(180.42±20.18)ng/L]血清胃动素水平显著高于开腹组,差异有统计学意义(P<0.05)。随访3个月,腹腔镜组愈合优良率(96.00% vs 80.00%)显著高于开腹组,差异有统计学意义(P<0.05)。结论 与开腹修补术比较,腹腔镜修补术可有效减少老年DUP患者手术创伤及并发症的发生,有利于患者术后胃肠功能的恢复,值得临床进一步推广。
英文摘要:
      Objective To determine the efficacy of laparoscopic and open neoplasty on elderly patients with duodenal ulcer perforation (DUP). Methods Totally 100 elderly DUP patients admitted in our hospital from March 2014 to March 2017 were enrolled in this study. According to the treatment, they were divided into laparoscopy group and open surgery group, with 50 patients in each group. The therapeutic efficacy, incidences of complications and serum motilin level were compared between the 2 groups. SPSS statistics 22.0 was used for data processing. Student’s t test or Chi-square test was employed for the comparison between groups according to the data types. Results The time of getting out of bed [(28.87±3.07) vs (38.02±4.22) h], length of hospital stay [(3.69±0.82) vs (5.75±1.03) d], time to first flatus [(15.08±1.63) vs (27.36±2.86) h], time to bowel sound [(64.58±6.62) vs (81.46±8.36) h], intraoperative blood loss [(52.45±5.27) vs (76.74±8.04) ml], and incidence of complications (10.00% vs 28.00%) were significantly lower in the laparoscopic group than in the open surgery group. The patients of the laparoscopic group also had higher serum motilin level in 1 d [(182.43±19.52) vs (233.59±25.47) ng/L] and 2 d [(156.37±16.24) vs (180.42±20.18) ng/L] postoperatively when compared with the other group (P<0.05). In 3 months’ follow-up, the excellent healing rate was obviously higher in the laparoscopic group than in the open surgery group (96.00% vs 80.00%, P<0.05). Conclusion Compared with open surgery, laparoscopic neoplasty effectively reduces the trauma and occurrence of complications in elderly DUP patients, and is beneficial for the postoperative recovery of gastrointestinal function. It is worth of further clinical promotion.
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