目的探讨胃大部切除术治疗消化性溃疡急性穿孔的临床价值,旨在提高该病Ⅰ期手术治愈的成功率。方法对37例消化性溃疡急性穿孔的临床资料进行分析和总结,采用胃大部连同病灶切除术,Ⅰ期治愈;胃肠重建采用BillrothⅠ式吻合6例(16.21%);BillrothⅡ式吻合31例(83.78%),其中BillrothⅡ式结肠前吻合18例(58.06%),结肠后吻合13例(41.94%)。结果术后无死亡病例,无术后残端瘘、吻合口漏、输入输出袢梗阻及倾倒综合症等严重并发症发生,切口感染1例(2.7%)。随访时间5年以上,其余均恢复正常。结论消化性溃疡急性穿孔Ⅰ期行胃大部切除术治疗,在解决穿孔的同时,又去除了溃疡病灶和泌酸环境,达到了根治的目的,远近期疗效均确切,是治疗APPU较理想的手术方式。 Objective To investigate the clinical value of subtotal gastrectomy in the treatment of acute perforation of peptic ulcer with the purpose of improving the success rate of first-stage surgical cure of the disease. Methods The clinical data of 37 cases of peptic ulcer acute perforation were analyzed and summarized. The majority of the stomach was treated with resection of the lesion and was cured in the first stage. Six cases (16.21%) were treated with Billroth Ⅰ anastomosis and the other 31 cases were treated with Billroth Ⅱ anastomosis 83.78%). Among them, 18 cases (58.06%) were anastomosed with Billroth Ⅱ colon and 13 cases (41.94%) were anastomosed after colon. Results No postoperative death cases, no postoperative stump fistula, anastomotic leakage, I / O obstruction and dumping syndrome and other serious complications, incision infection in 1 case (2.7%). Follow-up time of more than 5 years, the rest returned to normal. Conclusions Peptic ulcer acute perforation stage Ⅰ gastrectomy treatment, in addressing the perforation, but also remove the ulcer lesions and oxyntic acid environment, to achieve the purpose of radical, far and near-term efficacy are accurate, is the ideal treatment APPU Surgical approach.