单纯开腹修补术与胃大部切除术治疗胃十二指肠溃疡穿孔的效果对比

目的对比分析单纯开腹修补术与胃大部切除术治疗胃十二指肠溃疡穿孔的疗效。方法选择2011年2月—2014年1月于该院收治并行手术治疗的胃十二指肠溃疡穿孔患者86例,随机分为修补组与切除组（n=43）。修补组患者手术方式为单纯开腹修补术,切除组患者手术方式为胃大部切除术。对比两组患者手术时间、术中出血量、住院时间、术后并发症及复发溃疡发生情况。结果修补组患者手术时间（70.6±9.8）min、术中出血量（79.7±20.9）m L、住院时间（8.8±2.1）d,术后并发症发生率（4.7%）低于切除组,差异有统计学意义（P〈0.05）;两组患者溃疡复发率差异无统计学意义（P〉0.05）。结论单纯开腹修补手术与胃大部切除术对胃十二指肠溃疡穿孔均有较好疗效,但是单纯修补术术中出血少,还能够缩短手术时间、减少切口愈合所需要的时间、减少术后并发症的发生,更值得临床推广。

Comparion of the Effect Between Simple Open Repair and Subtotal Gastrectomy for the Treatment of Gastroduodenal Ulcer Perforation

Objective To compare and analyze the effect between simple open repair and subtotal gastrectomy for the treatment of gastroduodenal ulcer perforation. Methods 86 cases with gastroduodenal ulcer perforation underwent surgical treatment in our hospital from February 2011 to January 2014 were selected and randomly divided into the repair group andthe resection group with 43 cases in each. The repair group were treated by simple open repair, and the resection group were treated by snbtotal gastrecto- my. And the duration of the operation, intraoperative blood loss, length of stay, incidence of postoperative complications, and recurrence of ulcer were compared between the two groups. Results The duration of operation of the repair group was （70.6±9.8）min, intraoperative blood loss was （79.7±20.9） mL, the length of stay was （8.8±2.1） d, the incidence of postoperative complications was 4.7%, less than that of the resection group, respectively, the differences were statistically significant, P〈0.05; the difference in the recurrence rate of ulcer between the groups was not statistically significant （P〉0.05）. Conclusion Both simple open repair and subtotal gastrectomy have good curative effect on gastroduodenal ulcer perforation, but simple open repair has less intraoperative blood loss, shorter duration of operation and wound healing time, lower incidence of postoperative complications, so it is worthy of clinical promotion.