影响十二指肠溃疡穿孔单纯修补术预后的因素

目的　确定影响十二指肠溃疡穿孔单纯修补术预后的因素。方法　回顾性分析1991 年1 月到2003 年12 月宣武医院收治的95例十二指肠溃疡穿孔单纯修补术病人,从中找出与术后住院死亡及术后并发症发生的相关关系或高危因素。结果　术后病死率和并发症率分别为4.2%(4/95)和20.0%(19/95)。多因素分析只有术前休克(P=0.002)对死亡具有独立的预后意义;而从穿孔到手术的时间≥48 h是术前休克发生的独立的预测因素。穿孔到手术的时间(P=0.002)和合并重要器官疾病(P=0.003)对并发症的发生具有独立预测意义。结论　穿孔到手术的时间在48 h以内对于减少休克的发生有重要意义,病死率和并发症的发生率也随之降低;更应重视老年穿孔病人的治疗。

Prognostic Factors in Patients with Perforated Duodenal Ulcer Operated by Simple Closure

Objective To identify prognostic risk factors affecting mortality and morbidity in patients operated on perforated duodenal ulcer by simple suture. Methods A retrospective analysis of related-prognostic factors was carried out for eighty one patients with perforated duodenal ulcer consecutively operated on by simple suture procedure in Xuanwu hospital between January 1991 and December 2003. Correlative risk factors influencing postoperative hospitalized mortality and morbidity were identified from all analytic factors. Results Postoperative mortality and morbidity were 4.2%(4/95) and 20.0%(19/95) respectively. Multivariate analysis confirmed that only preoperative shock(P=0.002) was a independent predicted mortality significantly, while time from perforation to operation(P=0.002) and concomitant medical illness(P=0.003) were both significant factors that predicted morbidity independently. Conclusion It is important that time from ulcer perforation to operation should be shorten within forty-eight hours for reducing occurrence of shock, the mortality and morbidity will be reduced following the result metioned above. Treatment for older patients with perforated duodenal ulcer should be paid more attention.