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目的:探讨胃大部切除术和单纯修补术在急性胃穿孔中的应用效果。方法:选取我院2009年1月-2012年7月收治的急性胃穿孔患者242例,按随机化原则将其分为对照组124例和观察组118例,对照组施行胃大部切除术,观察组施行单纯修补术,比较两组患者的并发症、治疗有效率及住院时间。结果:对照组在多器官功能衰竭、腹腔感染、中毒性休克三方面的发生率显著高于观察组,差异有统计学意义(p<0.05);死亡和切口感染方面,两组患者比较无显著性差异,无统计学意义(p>0.05)。对照组有效率为93.6%,观察组为97.5%,两组相比,差异无统计学意义(p>0.05)。观察组患者平均住院天数为7.1d,对照组患者平均住院天数为7.4d,两组比较,差异无统计学意义(p>0.05)。结论:对于急性胃穿孔患者,在内科治疗的基础上施行单纯修补术的疗效较胃大部切除术差异不显著。单纯穿孔修补术可显著减少复发率和并发症发生率,是临床上手术治疗急性胃穿孔的首选方法,值得进一步推广应用。
Objective: To investigate the effect of subtotal gastrectomy and simple repair in acute gastric perforation. Methods: A total of 242 patients with acute gastric perforation admitted from January 2009 to July 2012 in our hospital were divided into control group (124 cases) and observation group (118 cases) according to the principle of randomization. The control group was performed subtotal gastrectomy, The observation group was treated with simple repair, comparisons were made between two groups of patients, the treatment efficiency and hospital stay. Results: The incidence of multiple organ failure, abdominal infection and toxic shock in the control group was significantly higher than that in the observation group (p <0.05). There was no significant difference between the two groups in death and incision infection Sex differences, no statistical significance (p> 0.05). The effective rate was 93.6% in the control group and 97.5% in the observation group. There was no significant difference between the two groups (p> 0.05). The average length of stay in observation group was 7.1 days, while the average length of stay in control group was 7.4 days. There was no significant difference between the two groups (p> 0.05). Conclusion: For patients with acute gastric perforation, the curative effect of simple repair on the basis of medical treatment is not significantly different from that of subtotal gastrectomy. Simple perforation repair can significantly reduce the recurrence rate and the incidence of complications, is the preferred method of surgical treatment of acute gastric perforation, it is worth further promotion.