陶亮翁晓晖孔晓武陆逸庭

（医院医院普外科，海宁）

目的：总结腹腔镜技术诊治急性消化道穿孔的临床经验。方法：回顾性分析年1月~年1月例术前考虑急性消化道穿孔施行腹腔镜手术的临床资料，其中术前95例明确诊断为消化道穿孔，27例考虑急性消化道穿孔行腹腔镜探查。结果：胃溃疡穿孔72例，十二指肠球部溃疡穿孔38例，胆囊穿孔3例，腹内疝2例，小肠穿孔3例，横结肠恶性肿瘤穿孔1例，乙状结肠自发性穿孔1例，阑尾穿孔2例；穿孔直径0.3～1.3cm，平均0.6cm。手术均获成功，无任何手术并发症。术后患者疼痛轻微，均未使用止痛剂。切口均甲级愈合。术后住院5~9d，平均6.5d。术后随访3~18个月，平均16个月，无穿孔复发、肠梗阻等并发症。结论：腹腔镜手术治疗胃十二指肠溃疡穿孔安全可靠，对于难以明确诊断的消化性溃疡穿孔，可以早期进行腹腔探查，对不同疾病进行镜下手术治疗。

腹腔镜；胃十二指肠溃疡穿孔

ExperienceofLaparoscopicTechnologyintheEarlyDiagnosisandTreatmentofDigestiveTractPerforationTaoLiang,WengXiaohui,KongXiaowu,etal.DepartmentofGeneralSurgery,ZhejiangPeople’sHospitalHainingHospital,Haining,China

ObjectiveTosummarizetheclinicalexperienceoflaparoscopictechniqueinthediagnosisandtreatmentofacuteperforationofdigestivetract.MethodsAretrospectiveanalysiswasmadeoncasesofacutegastrointestinalperforationtreatedbylaparoscopicsurgeryinourhospitalfromJanuarytoJanuary,95ofwhichweredefinitelydiagnosedasdigestivetractperforationbeforesurgeryand27ofwhichweresuspectedasacutegastrointestinalperforationforlaparoscopicexploration.ResultsTherewere72casesofgastriculcerperforation,38casesofduodenalulcerperforation,3casesofgallbladderperforation,2casesofintra-abdominalhernia,3casesofsmallbowelperforation,1caseofmalignantneoplasmperforationoftransversecolon,1caseofspontaneousperforationofsigmoidcolon,and2casesofappendicealperforation.Theperforationdiameterwas0.3-1.3cm(mean,0.6cm).Alltheoperationsweresuccessfulwithout







































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