两种手术方式治疗胃及十二指肠溃疡穿孔的临床效果观察.docVIP

两种手术方式治疗胃及十二指肠溃疡穿孔的临床效果观察 　　【摘要】 目的：对比两种手术方式在治疗胃及十二指肠溃疡穿孔方面的临床效果。方法：选取2012年1月-2014年1月本院收治的70例胃及十二指肠溃疡穿孔患者作为研究对象，按照双盲法将其分为对照组和观察组，每组各35例。对照组采用胃大部切除术进行治疗，观察组采用单纯修复术联合药物治疗。观察比较两组患者的手术时间、住院时间及并发症情况。术后1年随访患者的复发情况。结果：两组患者均顺利完成手术，观察组患者的手术时间和住院时间均明显短于对照组，并发症发生率2.9%明显低于对照组的22.9%，差异均有统计学意义（P中国论文网 /6/view-7251504.htm 　　【关键词】 手术方式； 胃十二指肠溃疡； 穿孔 　　Clinical Effect Observation of Two Surgical Procedures in the Treatment of Gastric and Duodenal Ulcer Perforation/YANG Yong-gang，CHEN Xiao-juan.//Medical Innovation of China，2016，13（09）：127-129 　　【Abstract】 Objective：To contrast the clinical effect of two surgical procedures in the treatment of gastric and duodenal ulcer perforation.Method：Seventy patients with gastric and duodenal ulcer perforation admitted to our hospital from January 2012 to January 2014 were selected as the research objects，they were divided into the control group and the observation group，35 cases in each group.The control group was treated with subtotal gastrectomy，the observation group was treated with simple repair joint drug therapy.The surgery time，hospitalization time and complications between the two groups were observed and compared.The recurrence of patients was followed up after 1 year of surgery.Result：The patients of two groups were successfully completed surgery.The surgery time and hospitalization time of the observation group were significantly shorter than those of the control group，the incidence of complications in the observation group was 2.9%，which was significantly lower than 22.9% of the control group，the differences were statistically significant（P 　　27例，女8例；年龄34～50岁，平均（37.5±3.6）岁。两组患者的性别、年龄等一般资料比较差异均无统计学意义（P0.05），具有可比性。 　　1.2 方法 两组患者入院后均给予常规检查和治疗，确诊病情后选择手术治疗，根据患者具体情况选择不同的手术方法。 　　1.2.1 观察组 观察组采用单纯穿孔修复术联合药物治疗，对患者穿孔处以丝线进行缝合，再以大网膜覆盖后固定，避免腹腔渗液发生积聚，控制好腹腔引流[1]。术后给予患者常规药物治疗，选择抗生素预防发生感染，应用减压药物缓解患者胃肠压力，待患者恢复正常饮食后要抑制酸性食物摄入[2]。 　　1.2.2 对照组 对照组采用胃大部切除术治疗，在患者胃窦前壁选择切口对胃十二指肠情况进行探查，找到溃疡处对渗液进行清理，再将胃窦切开并情理干净残端，把胃大部切除后，实施胃空肠吻合术，再为患者放置引流管，给予抗生素预防感染发生[3]。