不同术式治疗急性胃穿孔的临床效果观察.docVIP

不同术式治疗急性胃穿孔的临床效果观察 　　[摘要] 目的 观察胃大部分切除术与单纯修补术治疗急性胃穿孔的效果，为急性胃穿孔的临床治疗提供参考。 方法 选择2011年1月～2013年1月于河南省封丘县中医院普外科行手术治疗的急性胃穿孔患者48例，根据采用的术式不同分为单纯修补组和胃大部分切除组，每组各24例。术后随访1年，观察并比较两组的治疗效果、手术时间、下床活动时间、胃肠功能恢复时间及住院时间、并发症与复发情况。 结果 单纯修补组的总有效率为95.83%，胃大部分切除组为83.33%，单纯修补组的总有效率显著高于胃大部分切除组，差异有统计学意义（P0.05）。单纯修补组的复发率为8.33%，胃大部分切除组为4.17%，单纯修补组的复发率高于胃大部分切除组，差异有统计学意义（P0.05）。 结论 单纯修补术和胃大部分切除术治疗急性胃穿孔均取得一定的效果，且两种方法各有优劣性，临床中应根据患者的具体情况确定治疗方式。 　　[关键词] 急性胃穿孔；胃大部分切除术；单纯修补术 　　[中图分类号] R573 [文献标识码] A [文章编号] 1674-4721（2014）08（b）-0033-03 　　[Abstract] Objective To observe the effect of partial gastrectomy and simple perforation repair in the treatment of acute gastric perforation，in order to provide a reference for gastric perforation clinical treatment. Methods 48 patients with acute gastric perforation given operative treatment in Department of General Surgery，hospital of Traditional Chinese Medicine of Fengqiu County in Henan Province were selected.According to the surgical method，patients were divided into the simple perforation repair group and partial gastrectomy group，which given simple perforation repair treatment and partial gastrectomy treatment respectively，each group had 24 cases.All patiens were follow-up for 1 year.The therapeutic effect，duration of operation，ambulation time，gastrointestinal function recovery time，hospital stays，complications and recurrence were observed and compared between the two groups. Results The total effective rate of the simple perforation repair group was 95.83%，which of the partial gastrectomy group was 83.33%，the simple perforation repair group was higher than the partial gastrectomy group，the difference was statistically significant （P0.05）.The recurrence rate in the simple perforation repair group was 8.33%，which was higher than that in the partial gastrectomy group （4.17%），the difference was statistically significant （P 　　[Key words] Acute gastric perforation；Partial gastrectomy；Simple perforation repair 　　胃穿孔是外科常见的急腹症，主要病因为胃溃疡，其次为胃癌[1]。近年来，随着人们生活水平的提高