急性胃穿孔患者胃大部分切除术疗效观察及对预后影响研究.docVIP

急性胃穿孔患者胃大部分切除术疗效观察及对预后影响研究 　　【摘要】 目的：探讨急性胃穿孔患者采用胃大部分切除术治疗的临床效果及对预后的影响。方法：回顾性分析本院2013年3月-2014年5月收治的急性胃穿孔患者102例，将行单纯修补术治疗的53例患者作为对照组，行胃大部分切除术治疗的49例患者作为观察组，对比两组临床治疗效果、住院时间、住院费用、术后并发症发生情况、复发情况等。结果：观察组临床治疗总有效率为95.9%，并发症发生率为10.2%，与对照组的92.5%、11.3%比较差异无统计学意义（P0.05），且两组住院时间、住院费用比较差异无统计学意义（P0.05）。观察组溃疡复发率为4.1%，无再次穿孔情况发生，低于对照组的20.8%、7.5%，两组比较差异均有统计学意义（P0.05）。结论：单纯修补术或胃大部分切除术治疗急性胃穿孔的效果相当，能有效改善患者临床症状，促进病情恢复，但临床治疗时对条件符合及在患者允许的条件下，应尽量选择胃大部分切除术治疗，以防止溃疡复发导致再次穿孔发生。 　　【关键词】 急性胃穿孔； 单纯修补术； 胃大部分切除术； 临床效果； 预后 　　【Abstract】 Objective：To explore the clinical effects of subtotal gastrectomy applied and treated on patients with acute gastric perforation and its impacts of prognosis.Method：102 patients with acute gastric perforation admitted by the hospital from March 2013 to May 2014 were retrospectively analyzed，53 patients were treated with simple repairs as control group，49 patients were given subtotal gastrectomy as the observation group.The clinical outcomes，stay length，hospitalization cost and the incidence and recurrence of postoperative complications in two groups were compared.Result：The total effective rate and the occurrence rate of observation group were respectively 95.9% and 10.2%，when compared to those indexes in the control group of 92.5% and 11.3%，the differences were not statistically significant（P0.05）；the comparisons in hospital stay and hospital cost of two groups compared，the differences were no statistically significant （P0.05）.The recurrence rate of ulcers in the observation group was 4.1%，no perforation condition reoccurs， being lower that control group of 20.8% and 7.5%，the differences were statistically significant（P0.05）.Conclusion：Simple repair or subtotal gastrectomy deliver equivalent effects in treating acute gastric perforation， and both of them can effectively improve clinical symptoms of patients， promote the recovery of diseases， but subtotal gastrectomy treatment is preferentially chosen greatest extend when qualifications are met and the patients are a