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目的:探讨应用不同手术方式治疗十二指肠溃疡急性穿孔的临床疗效。方法:对近年来收治的十二指肠溃疡急性穿孔的病例分别采取开腹下单纯修补术+高选择迷走神经离断术(PCV)、胃大部切除术、腹腔镜下行穿孔修补术+PCV。对比分析其手术及住院的时间、并发症、复发率。结果:腹腔镜下行穿孔修补术+PCV可明显缩短住院时间,减少术后并发症。但相比胃大部切除术,溃疡复发率稍高。结论:腹腔镜下行穿孔修补术+PCV,操作简便,切口小,患者痛苦小,恢复快,明显缩短住院时间,术后加以抗酸、抑Hp等内科治疗,临床效果较好。
Objective: To investigate the clinical effects of different surgical methods in the treatment of acute perforation of duodenal ulcer. Methods: The cases of acute perforation of duodenal ulcer admitted in recent years were treated by simple open surgery, high selective vagotomy (PCV), subtotal gastrectomy and laparoscopic perforation repair + PCV respectively. Comparative analysis of the operation and hospitalization time, complications, recurrence rate. Results: Laparoscopic perforation repair + PCV can significantly reduce hospital stay and reduce postoperative complications. However, compared with subtotal gastrectomy, ulcer recurrence rate slightly higher. Conclusions: Laparoscopic perforation repair + PCV is simple and easy to operate with small incision. It is less painful and quicker to recover. It significantly shortens the length of hospital stay and is effective in the treatment of acid and Hp after operation.