胃十二指肠溃疡急性穿孔手术治疗的临床研究

目的探讨胃十二指肠溃疡急性穿孔手术治疗的效果。方法选择2009年7月~2010年1月在我院进行胃十二指肠溃疡急性穿孔手术患者64例作为研究对象,所有患者根据随机数字表法分为两组,观察组32例行胃大部切除术,对照组32例行传统缝合修补术,观察比较两组的手术时间、术中出血量、下床活动时间、住院时间及术后随访复发情况。结果观察组32例行胃大部切除术患者的手术时间长,术中出血量多,术后下床活动时间晚,平均住院时间长,差异有统计学意义(P<0.05)。随访2年,观察组行胃大部分切除术组未见复发性溃疡,对照组再次行Ⅱ期胃大部分切除术2例,经再次治疗后未见复发性溃疡。结论胃十二指肠溃疡单纯穿孔修补术和胃大部切除术治疗胃十二指肠溃疡穿孔各具优缺点,临床医生可根据各自适应证选择适合患者的手术方式。

Clinical study of surgical treatment of acute perforation of gastroduodenal ulcer

Objective To investigate the effect of acute perforation of gastroduodenal ulcer surgery. Methods Gastric ulcer surgery 64 cases in our hospital from July 2009 to January 2010 were selected as the object, all patients were randomly di- vided into two groups according to the random number table; the observation group 32 cases underwent gastrectomy and control group 32 cases underwent traditional suture repair, then were compared on operative time, intraoperative blood loss, ambulation time, hospital stay and postoperative follow-up recurrence between the two groups. Results Observed group of 32 routine gastrectomy in patients with long operative time, blood loss, postoperative ambulation activities of late, the aver- age length of stay for a long time, the difference was significant （P 〈 0.05）. 2-year followed-up observation group under- went partial gastreetomy group had no recurrent ulcers. The control group again for phase Ⅱ partial gastrectomy had two cases, no recurrent ulcers after retreatment. Conclusion Gastric ulcer simple perforation repair and partial gastric resec- tion for stomach and duodenal ulcer perforation, each with advantages and disadvantages of surgery for patients, clinicians in accordance with their respective indications.