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目的探讨单纯修补术与胃大部分切除术治疗消化性溃疡穿孔的临床疗效。方法随机选取我院2010年9月-2011年12月诊治的急性良性胃十二指肠穿孔患者74例,随机分为观察组44例和对照组30例,分别采用腹腔镜下单纯穿孔修补术和传统开腹胃大部分切除术治疗,观察两组创伤性、并发症及远期疗效。结果观察组的手术时间和术中出血量分别为78.3±10.2min和22.0±5.9ml,均明显低于对照组,差异有统计学意义(P<0.05);并发症(切口感染、腹腔脓肿、再穿孔)发生率两组比较无统计学差异(P>0.05);患者随访2-5年,观察组溃疡复发症状改善优于对照组,差异有显著性(P<0.05),且两组溃疡复发率无统计学差异(P>0.05)。结论胃大部分切除术不是治疗消化性溃疡穿孔的首选方式,单纯穿孔修补术具有创伤性小、并发症少及远期疗效显著等优点,值得临床首选使用。
Objective To investigate the clinical efficacy of simple repair and partial gastrectomy in the treatment of peptic ulcer perforation. Methods Totally 74 acute gastroduodenal perforation patients diagnosed and treated in our hospital from September 2010 to December 2011 were randomly divided into observation group (44 cases) and control group (30 cases). Laparoscopic perforation repair And the majority of traditional laparotomy resection treatment, trauma, complications and long-term efficacy were observed. Results The operation time and intraoperative blood loss in the observation group were 78.3 ± 10.2min and 22.0 ± 5.9ml, respectively, which were significantly lower than those in the control group (P <0.05). Complications (incision infection, abdominal abscess, (P> 0.05). After the patients were followed up for 2 to 5 years, the improvement of ulcer recurrence in observation group was better than that in control group (P <0.05), and the incidence of ulcer The recurrence rate was no significant difference (P> 0.05). Conclusion Most resection of stomach is not the first choice for the treatment of peptic ulcer perforation. Perforation repair has the advantages of less invasiveness, fewer complications and long-term curative effect, which is worth to be used clinically.