论文部分内容阅读
目的研究十二指肠溃疡穿孔的两种不同疗法——穿孔修补术加近侧胃迷走神经切断术（ＰＧＶ）与穿孔修补术加奥美拉唑方案的临床疗效。方法将１９９４年１月－１９９６年１２月相继入院的４８例十二指肠溃疡穿孔患者随机分为Ａ、Ｂ两组。Ａ组（２１例）在穿孔修补术的基础上，加行ＰＧＶ。Ｂ组（２７例）仅作穿孔修补术，术后辅予奥美拉唑方案（即口服奥美拉唑加羟氨苄青霉素加灭滴灵）。术后定期随访。随访结果按Ｖｉｓｉｃｋ标准分级。结果Ａ组术后半年和２年疗效优良者（ＶｉｓｉｃｋⅠ加Ⅱ级）分别为１８例（８５．７％）和１７例（８１．０％），溃疡复发者（ＶｉｓｉｃｋⅣ级）分别为１例（４．８％半年）和２例（９．５％２年）。Ｂ组术后半年和２年疗效优良者分别为１９例（６６．７％）和１０例（３７．０％），溃疡复发者分别为５例（１８．５％）和１２例（４４．５％）。Ａ组疗效优于Ｂ组（Ｐ＜０．０１）。Ｈｐ检测，Ａ组术后半年和两年的Ｈｐ阳性率分别为８１．０％和８５．７％（Ｐ＞０．０５）；Ｂ组分别为１８．５％和５１．９％（Ｐ＜０．０１）。结论十二指肠溃疡穿孔在施行修补术后，应同时加行ＰＧＶ，以提高对溃疡病的根治效果
Objective To study the clinical efficacy of two different therapies for perforation of duodenal ulcer, perforation repair plus proximal gastric vagotomy (PGV) and perforation repair plus omeprazole. Methods 48 cases of duodenal ulcer perforation who were admitted to hospital from January 1994 to December 1996 were randomly divided into A and B groups. Group A (21 cases) in the perforation repair based on the addition of PGV. Group B (27 cases) was only used for perforation repair, and postoperatively received omeprazole regimen (oral omeprazole plus amoxicillin plus metronidazole). Regular follow-up after surgery. Follow-up results were graded according to Visick criteria. Results In group A, 18 patients (85.7%) and 17 patients (81.0%) were treated with Visick Ⅰ and Ⅱ, respectively, and those with Visick Ⅳ grade were 1 ( 4.8% for six months) and two cases (9.5% for two years). In group B, 19 cases (66.7%) and 10 cases (37.0%) had excellent curative effect at 6 months and 2 years after operation, respectively, and 5 cases (18.5%) and 12 cases (44.5%) had ulcer recurrence respectively. 5%). The efficacy of group A was better than that of group B (P <0.01). In H group, the positive rates of Hp in group A were 81.0% and 85.7% at 6 months and 2 years respectively (P> 0.05), while those in group B were 18.5% and 51.9% (P < 0.01). Conclusions Perforation of duodenal ulcer should be accompanied by PGV after perforation to improve the curative effect of ulcer disease