评价胃大部切除术与单纯穿孔修补术治疗胃十二指肠溃疡穿孔临床疗效.docVIP

评价胃大部切除术与单纯穿孔修补术治疗胃十二指肠溃疡穿孔临床疗效 　　【摘要】 目的 比较分析胃大部切除术与单纯穿孔修补术治疗胃十二指肠溃疡穿孔的疗效。 　　方法 83例胃十二指肠溃疡穿孔患者， 采用计算机随机分组法分为Ⅰ组（41例）和Ⅱ组（42例）。Ⅰ组患者给予胃大部切除术治疗， Ⅱ组患者给予单纯穿孔修补术治疗。比较两组患者的治疗效果、手术时间、住院时间及并发症发生情况。结果 Ⅱ组患者治疗总有效率为97.62%， 明显高于Ⅰ组的82.93%， 差异有统计学意义（Plt;0.05）。Ⅱ组患者手术时间、住院时间短于Ⅰ组， 并发症发生率低于Ⅰ组， 差异有统计学意义（Plt;0.05）。结论 临床治疗胃十二指肠溃疡穿孔可采用单纯穿孔修补术治疗， 其疗效显著， 并发症 　　少， 较胃大部切除术更有优势。 　　【关键词】 胃十二指肠溃疡穿孔;胃大部切除术;单纯穿孔修补术 　　DOI：10.14163/j.cnki.11-5547/r.2018.07.012 　　【Abstract】 Objective To compare and analyze the efficacy of subtotal gastrectomy and simple perforation repair in the treatment of gastroduodenal ulcer perforation. Methods A total of 83 patients with gastroduodenal ulcer perforation were divided by computer random grouping method into group Ⅰ （41 cases） and group Ⅱ （42 cases）. 　　Group Ⅰ was treated with subtotal gastrectomy， and group Ⅱ was treated with simple perforation repair. Comparison were made on treatment effect， operation time， hospitalization time and occurrence of complications between the two groups. Results Group Ⅱ had obviously higher total treatment effective rate as 97.62% than 82.93% in group Ⅰ， and the difference was statistically significant （Plt;0.05）. Group Ⅱ had shorter operation time and hospitalization time than group Ⅰ， and lower incidence of complications than group Ⅰ. Their difference was statistically significant （Plt;0.05）. Conclusion Simple perforation repair can be used for clinical treatment of gastroduodenal ulcer perforation， and its efficacy is remarkable with less complications. It has more advantages than subtotal gastrectomy. 　　【Key words】 Gastroduodenal ulcer perforation; Subtotal gastrectomy; Simple perforation repair 　　胃十二指?c溃疡为外科的常见急腹症， 可逐渐向深部发展， 可穿过胃或十二指肠壁， 从而引起穿孔。穿孔是胃十二指肠溃疡的常见并发症， 在胃十二指肠溃疡患者中， 有20%～30%伴有穿孔[1]。引起胃十二指肠溃疡穿孔的原因与长期药物作用、胃内压增加、劳累、长期吸烟饮酒有关。由于该病发病急， 病情进展快， 病情危重， 易导致中毒性休克而危及患者生命[2]。为评价胃大部切除术与单纯穿孔修补术治疗胃十二指肠溃疡穿孔的疗效， 现采用随机、双盲、对照试验进行研究， 现报告如下。 　　1 资料与方法 　　1. 1 一般资料 选择本院2015年5月～2017年7月外科接诊的83例胃十二指肠溃疡穿孔患者作为研究对象， 采用计算机随机分组法分为Ⅰ组（41例）和Ⅱ组（4