Conservative treatment of upper gastrointestinal tract perforation of 43 cases.docVIP

 PAGE \* MERGEFORMAT 8 Conservative treatment of upper gastrointestinal tract perforation of 43 cases [Keywords:] on the digestive tract perforation; conservative treatment Upper gastrointestinal tract perforation is common general surgical acute abdomen, once diagnosed, most of the clinical emergency surgical treatment in our hospital from January 2002 ~ December 2009 between the use of non-surgical treatment of 43 cases of upper gastrointestinal perforation, the effect Yes, these are as follows. Clinical data 1. General Information The group of 43 patients, 36 males and 7 females. Aged 17 to 42 years, mean age 26.5 years old. Duration of up to 6 hours, the shortest 1.5 hours, the average duration of 3.5 hours, including 35 cases of perforation of fasting. Past history of 17 patients with gastric disease, 8 cases have been diagnosed as previous gastric or duodenal ulcer .2 antecedent trauma patients admitted to hospital oral non-steroidal drugs more than 1 week 1 case because of long-term use of non-rheumatoid arthritis .12 cases of steroid drugs has a long history of alcohol abuse. admission abdominal X ray or CT examination diagnosed 35 cases, 8 cases of conservative treatment for 6 to 8 hours after the review of abdominal X ray diagnosis. 2. Treatment of all patients immediately after admission to decompression, good surgical preparation, while intravenous proton pump inhibitor and broad-spectrum antibiotics, subcutaneous octreotide, and actively maintain water and electrolyte balance. Conservative close observation of patients during treatment signs of abdominal pain and abdominal conditions, 4 to 6 hours after the conservative no relief of abdominal pain, peritonitis signs increase that is seen as conservative treatment fails, the surgical treatment. conservative treatment B during the abdominal ultrasound every other day, to understand the situation ascites. If encapsulated effusion, in B-guided drainage. conservative treatment for 5 days,