Efficacy of laparoscopic perforation repair on duodenal ulcer complicated with gastric perforation in the middle-aged and elderly and the influence on gastrointestinal motility
Objective To analyze the clinical effect of laparoscopic perforation repair on duodenal ulcer complicated with gastric perforation in the middle-aged and elderly and the influence on gastrointestinal motility.Methods 78 patients with duodenal ulcer and gastric perforation as the observation subjects,and were divided into an observation group(laparoscopic perforation repair,39 cases)and a control group(conventional surgery,39 cases)according to the random number method.The clinical efficacy,intraoperative bleeding volume,postoperative anal exhaust time,bowel sound recovery time,hospitalization time,complications(incision infection,intestinal obstruction,space infection),Barthel index and visual analogue scale(VAS)score before and after treatment were compared between the two groups.Results The total effective rate of the observation group was 89.7%,which was higher than 71.8%of the control group,and the difference was significant(P<0.05).After treatment,VAS score in both groups was lower than that before treatment,and Barthel index was higher than that before treatment;VAS score of(1.69±0.15)points in the observation group was lower than(3.45±0.12)points in the control group,and the Barthel index of(91.45±3.23)points was higher than(81.23±6.15)points in the control group(P<0.05).The observation group had postoperative anal exhaust time of(27.72±5.23)h,bowel sound recovery time of(12.41±4.23)h,hospitalization time of(5.23±0.23)d,which were shorter than(42.39±3.53)h,(27.51±3.34)h,(10.88±1.22)d in the control group;the intraoperative bleeding volume was(42.62±3.23)ml in the observation group,which was significantly less than(73.24±5.31)ml in the control group(P<0.05).The incidence of complications in the observation group was 10.3%,which was lower than 30.8%in the control group,and the difference was significant(P<0.05).Conclusion In middle-aged and elderly patients with duodenal ulcer and gastric perforation,laparoscopic perforation repair can obviously improve the therapeutic effect,reduce postoperative pain more than conventional surgery,and promote the recovery of gastrointestinal function and reduce the incidence of postoperative complications,which is worthy of promotion.
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