[摘要] 目的 分析胃大部分切除術与单纯修补术治疗急性胃穿孔的临床疗效。 方法 选择2015年8月～2016年8月间80例急性胃穿孔患者进行回顾性分析，并根据手术方法分组，各40例。A组采取胃大部分切除术，B组则采取单纯修补术方案。比较两组急性胃穿孔病情改善率；病灶切除或穿孔缝合耗时、术后肠鸣音恢复时间、手术后康复出院时间；分析住院期间出现的并发症现象，出院后随访1年对比两组急性胃穿孔复发情况。 结果 两组患者疗效总有效率比较差异无统计学意义（P>0.05）；B组病灶切除或穿孔缝合耗时、术后肠鸣音恢复时间、手术后康复出院时间短于A组（P<0.05）；出院后随访1年对比两组急性胃穿孔复发情况显示B组复发率更低（P<0.05）；住院期间出现并发症方面，B组显著低于A组（P<0.05）。 结论 胃大部分切除术与单纯修补术治疗急性胃穿孔的临床疗效相当，其中胃大部分切除术可彻底切除病灶，降低复发率，但损伤较大，术后并发症多，住院时间和康复时间长，而单纯修补术则和胃大部分切除术相反，损伤较小、康复较快、并发症少，但因单纯修补无法彻底清除病灶复发率较高。
　　[关键词] 胃大部分切除术；单纯修补术；急性胃穿孔；复发；并发症
　　[中图分类号] R656.6 [文献标识码] B [文章编号] 1673-9701（2017）34-0049-03
　　Clinical effect of subtotal gastrectomy and simple repair on acute gastric perforation
　　GAO Shenggui
　　Department of General Surgery，Foshan City Nanhai District Fifth People’s Hospital in Guangdong Province， Foshan 528231，China
　　[Abstract] Objective To analyze the clinical effect of subtotal gastrectomy and simple repair on acute gastric perforation. Methods 80 patients with acute gastric perforation from August 2015 to August 2016 were selected and retrospectively analyzed，which were divided into groups according to the operation method， with 40 cases in each group. Group A underwent subtotal gastrectomy. Group B underwent simple repair program. The rate of improvement of acute gastric perforation， the time of lesions removal or perforation suture， the recovery time of postoperative bowel sounds and the rehabilitation discharge time after surgery were compared between the two groups. The complication symptoms during hospitalization were analyzed. Within follow-up for 1 year after discharge， the recurrence of acute gastric perforation between the two groups was compared. Results There was no statistically significant difference in the rate of total effective between the two groups（P>0.05）. The time of lesions removal or perforation suture， the recovery time of postoperative bowel sounds and the rehabilitation discharge time after surgery in group B were shorter than those of the group A（P<0.05）. During follow-up for 1 year after discharge， the recurrence of acute gastric perforation between the two groups was compared. The results showed that the recurrence rate of acute gastric perforation was lower in group B（P<0.05）. Complications in group B during hospitalization were significantly lower than those in group A（P<0.05）. Conclusion The subtotal gastrectomy and simple repair have the same effect in the treatment of acute gastric perforation. The subtotal gastrectomy can completely remove the lesion， reduce the recurrence rate， but has great damage， more postoperative complications and long hospitalization and rehabilitation time. While simple repair is contrary to subtotal gastrectomy， and has less damage， faster recovery and fewer complications， but has high recurrence rate because that simple repair can not completely remove the lesion. 　　[3] Soreide K，Thorsen K，Soreide JA，et al. Predicting outcomes in patients with perforated gastroduodenal ulcers：Artificial neural network modelling indicates a highly complex disease[J]. European Journal of Trauma and Emergency Surgery：Official Publication of the European Trauma Society，2015，41（1）：91-98.
　　[4] 顾志祥. 单纯修补术与胃大部分切除术在急性胃穿孔治疗中的应用价值[J]. 中外医学研究，2017，15（8）：119-120.
　　[5] 王晓庆，刘丽娜，贺京军，等.胃大部术后胃内植物石的影像学5例报告分析[J].国际医药卫生导报，2012，18（2）：166-168.
　　[6] Faisal Aziz，Sherwani SK，Akhtar SS，et al.Development of an in-house enzyme-linked immunosorbent assay based on surface whole cell antigen for diagnosis of Helicobacter pylori infection in patients with gastroduodenal ulcer disease[J]. World Journal of Microbiology