四孔腹腔镜穿孔修补术用于胃十二指肠溃疡急性穿孔患者的效果及安全性

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Efficacy and Safety of Four-hole Laparoscopic Perforation Repair in Patients with Acute Perforation of Gastroduodenal Ulcer/QU Tao. //Medical Innovation of China， 2025， 22（12）： 021-024

[Abstract]Objective： To investigate the clinical effct of four-hole laparoscopic perforation repair in patients with acute perforation of gastroduodenal ulcer. Method： A total 60 patients with acute perforation of gastroduodenal ulcer admitted to from December 2022 to December 2024 were retrospectively analyzed anddivided into two groups according todiffrent surgical methods， with 30 cases in each group.The control group underwent traditionallaparotomy repair，and the observation group underwent fourhole laparoscopic perforation repair.Perioperative indexes， pain degree， inflammation indexes and complication rate between the two groups were compared. Result：The operation time， anal exhaust time，geting outof bed time， hospitalization time and incision length in theobservation group were shorter than those inthe control group， and the intraoperativebloodloss was less than that in the control group，the differences were statistically significant 0 P <0.05）.At6，24and 48h after operation， visual analogue scale （VAS）scores in theobservation groupwere lower than those in the control group， the differences were statistically significant （ P <0.05）.Before operation， there were no significant differences in inflammation indexes between the two groups （ P >0.05）. On the first day after operation， the hypersensitive C reactive protein （hs-CRP）and white blood cellcount （WBC）in the observation group were lower than those in the control group， the differences were statistically significant （ P <0.05）. The complication rate of the observation group was lower than that of the control group，the diference was statistically significant （ P <0.05）. Conclusion： Compared with traditional open repair，four-hole laparoscopic perforation repair for acute perforation of gastroduodenal ulcris moreeffective inoptimizing perioperative indexes，alleviating inflammation and pain， and reducing complications.

[Key words] Gastroduodenal ulcer Acute perforation Four-hole laparoscopic perforation repair Perioperative index Pain degree Inflammation index Complications

First-author's address： Gastrointestinal Hernia Surgery， . iupanshui 553000， China doi： 10.3969/j.issn.1674-4985.2025.12.006

胃十二指肠溃疡指发生在胃或十二指肠的慢性溃疡性病变，通常由胃酸、胃蛋白酶的消化作用引起，当溃疡病灶向深部发展，穿透胃或十二指肠的浆膜层时，即会引起急性穿孔，若未及时治疗，严重时会导致感染性休克，甚至危及生命-2。（剩余4967字）