单纯修补术治疗胃十二指肠溃疡穿孔远期疗效观察

目的观察对胃十二指肠溃疡穿孔患者采用单纯修补术的远期效果。方法对1990年2月至2005年5月间收治的胃十二指肠溃疡穿孔行单纯穿孔修补术患者74例进行随访。结果74例患者均获完整资料，术后溃疡症状复发率（visickⅢ—Ⅳ）为14．9％（11／74），其中胃溃疡复发率26．9％（7／26），十二指肠溃疡复发率8．3％（4／48），两者差异有统计学意义（x^2=4．782，P〈0．05）；术后半年复查56例，溃疡愈合率91．1％（51／56），术后一年复查46例，溃疡复发率10．9％（5／46），胃溃疡复发率（26．8％）明显高于十二指肠溃疡（3．1％）（x^2=4．651，P〈0．05）。结论单纯修补术治疗胃、十二指肠溃疡穿孔远期效果满意，对十二指肠溃疡穿孔治疗效果更佳。

Long-term therapeutic results in patients with perforated gastroduodenal ulcer operated on by simple closure and pharmacal management

Objective To investigate the long-term follow up results of patients with gastroduodenal ulcer perforation managed by simple suture and pharmacal management.Methods 74 patients with perforated gastroduodenal ulcer operated with simple closure and pharmacal management in hospital from February 1990 to May 2005 were observed,after operation the patients underwent follow-up.According to follow-up data,the long-term therapeutic results of these patients were determined.Results The rate of symptomatic ulcer recurrence(Visick Ⅲ-Ⅳ)was14.9%(26.9% in patients with gastric ulcer and 8.3% in duodenal ulcer)in 74 patients with perforated gastroduo denal ulcer operated on with simple closure and pharmacal management after operation.Both of them showed significant difference(Fisher' s Exact Test:P = 0.043).The incidence of long-term complications was 10.8% and there was no statistical difference between the patients with gastric ulcer and those with duodenal ulcer(Fisher's Exact Test:P =0.440).56 patients were surveyed by endoscopy or upper gastrointestinal series within 6 months after operation.The rate of cure was 91.1% ,significant difference was not observed between the patients with gastric ulcer and those with duodenal ulcer(Fisher' s Exact Test:P = 0.336).But after a year ulcer recurrence rate of total 46 patients was 10.9% and the gastric ulcer recurrence rate significantly higher than that of duodenal ulcer(Fisher's Exact Test;P = 0.047).Conclusion Long-term effect of patients with perforated gastroduodenal ulcer operated by simple closure and pharmacal management was satisfactory.But the former was less effective than the latter.