154例消化性溃疡穿孔的诊疗体会

目的:探讨消化性溃疡穿孔的诊断及治疗方法。方法:回顾分析2000～2005年收治的154例消化性溃疡穿孔患者临床表现、诊断及治疗方法。结果:154例中,术前确诊143例(92.8%),误诊11例(7.1%)。非手术治疗31例(20.1%),全部治愈;穿孔修补术35例(22.7%);胃大部切除术88例(57.1%);术后无十二指肠残端破裂、再穿孔、吻合口瘘等近期并发症。结论:术前X线、B超及腹腔穿刺联合应用可提高溃疡穿孔的确诊率,胃大部切除术与单纯溃疡穿孔修补术或非手术治疗近期并发症的发生无显著性差异,但远期疗效优于后两者。

Diagnosis and Treatment of 154 Cases Acute Perforation of Peptic Ulcer

Objective:To investigate the method diagnosis and surgical treatment of pepticulcer ,to improe the diagnosis and treatment . Methods:Retrospective analysis on the clinical data of 154 patients ,and the method diagnosis and treatment . With perforation of peptic ulcer in our hospital from 2000 to 2005 .Results:Out of the 154 cases,the diagnosis was made preoperatively in 143 cases (92.8%),and misdiagnosed in the other 11 cases (7.1%);31 cases (20.1%) underwent non-operative treatment ,35 cases (22.7%) underwent simple closure operation and 88 cases (57.1%) underwent subtotal gastrectomy ,after the operation there were no duodenal stumpruture ,no reperforation ,no the leak of stoma and early complication . Conclusions:Comdining use of X-ray ,B-ultrasoned with abdomiral paracentesis examination can apparently imporove the diagnosis rate,the early complication in subtotal gastrectomy group compariny with simple closure operation group and non-operative treatment group were no significant ,but the long-term effect of subtotal gastrectomy was much better than that of other two groups.