胃大部分切除术与单纯修补术治疗急性胃穿孔临床疗效观察.docVIP

胃大部分切除术与单纯修补术治疗急性胃穿孔临床疗效观察 　　[摘要] 目的 分析胃大部分切除?g与单纯修补术治疗急性胃穿孔的临床疗效。 方法 选择2015年8月～2016年8月间80例急性胃穿孔患者进行回顾性分析，并根据手术方法分组，各40例。A组采取胃大部分切除术，B组则采取单纯修补术方案。比较两组急性胃穿孔病情改善率；病灶切除或穿孔缝合耗时、术后肠鸣音恢复时间、手术后康复出院时间；分析住院期间出现的并发症现象，出院后随访1年对比两组急性胃穿孔复发情况。 结果 两组患者疗效总有效率比较差异无统计学意义（P0.05）；B组病灶切除或穿孔缝合耗时、术后肠鸣音恢复时间、手术后康复出院时间短于A组（P0.05）；出院后随访1年对比两组急性胃穿孔复发情况显示B组复发率更低（P0.05）；住院期间出现并发症方面，B组显著低于A组（P0.05）。 结论 胃大部分切除术与单纯修补术治疗急性胃穿孔的临床疗效相当，其中胃大部分切除术可彻底切除病灶，降低复发率，但损伤较大，术后并发症多，住院时间和康复时间长，而单纯修补术则和胃大部分切除术相反，损伤较小、康复较快、并发症少，但因单纯修补无法彻底清除病灶复发率较高。 　　[关键词] 胃大部分切除术；单纯修补术；急性胃穿孔；复发；并发症 　　[中图分类号] R656.6 [文献标识码] B [文章编号] 1673-9701（2017）34-0049-03 　　Clinical effect of subtotal gastrectomy and simple repair on acute gastric perforation 　　GAO Shenggui 　　Department of General Surgery，Foshan City Nanhai District Fifth Peoples Hospital in Guangdong Province， Foshan 528231，China 　　[Abstract] Objective To analyze the clinical effect of subtotal gastrectomy and simple repair on acute gastric perforation. Methods 80 patients with acute gastric perforation from August 2015 to August 2016 were selected and retrospectively analyzed，which were divided into groups according to the operation method， with 40 cases in each group. Group A underwent subtotal gastrectomy. Group B underwent simple repair program. The rate of improvement of acute gastric perforation， the time of lesions removal or perforation suture， the recovery time of postoperative bowel sounds and the rehabilitation discharge time after surgery were compared between the two groups. The complication symptoms during hospitalization were analyzed. Within follow-up for 1 year after discharge， the recurrence of acute gastric perforation between the two groups was compared. Results There was no statistically significant difference in the rate of total effective between the two groups（P0.05）. The time of lesions removal or perforation suture， the recovery time of postoperative bowel sounds and the rehabilitation discharge time after surgery in group B were shorter than th