无选择性非手术治疗胃十二指肠溃疡穿孔临床分析

目的探讨胃十二指肠溃疡穿孔（PGDU）无选择性非手术治疗的可行性和效果。方法90例PGDU患者于住院首日全部无选择地采用胃肠减压、防治感染、抑酸、支持治疗、促进胃肠功能恢复等非手术综合治疗。结果非手术治愈86例（95．6％），其中5例腹腔积液或脓肿行腹腔穿刺置管引流后痊愈，均未遗留相关并发症。中转手术急诊治疗3例（3．3％），另1例（1．1％）十二指肠溃疡合并肠外瘘非手术后择期手术治愈。结论非手术的现代综合治疗措施对绝大多数无严重并发症的PGDU行之有效，PGDU传统的手术治疗适应证应重新评估。

Non-selective and non-surgical treatment of perforated gastroduodenal ulcer

Objective To discuss the feasibility of non-selective and non-surgical treatment o perforatedgastroduodenal ulcer(PGDU).Methods Totally 90 cases with PGDU were enrolled.They were given un-selectednon-surgical therapies,such as gastric decompression,infection control,acid suppression,nutritional support,onthe first day of hospitalization.Results Eighty-six cases(95.6%)were cured,including 5 cases of abdominalabscess treated by catheterization recovered after left no complications.3 cases(3.3%)were converted toemergency surgical treatment and 1 case(1.1%)complicated with enteric fistula was cured by time-selectiveoperation.Conclusion Non-surgical comprehensive therapies are effective for majority of PGDU patients withoutsevere complications.Therefore,re-evaluation of traditional indications of surgical treatment of PGDU isrecommended.