“带蒂伞状胃壁”预防十二指肠残端瘘临床研究

Clinical study on preventing duodenum stump fistula used a stomach wall shaped like an umbrella linked with vessel

目的观察"带蒂伞状胃壁"预防十二指肠残端瘘的临床效果。方法随机将莱芜市中医医院外科自1988年1月～2008年2月收治的830例十二指肠球部溃疡出血和位置较高的胃溃疡出血、穿孔、经内科治疗无效的顽固性十二指肠球部溃疡或位置较高的胃溃疡、十二指肠球部和胃外伤破裂、刀刺伤病人分为2组。实验组516例,十二指肠残端缝合后,在十二指肠残端用"带蒂伞状胃壁"覆盖缝合加固。对照组314例,缝闭十二指肠残端后,在残端表面覆盖大网膜或胰腺被膜,观察两组术后并发症。结果对照组术后十二指肠残端瘘发生率为3.5%(11/314),实验组术后十二指肠残端瘘发生率明显降低,只占0.19%(1/516),P<0.01。对照组术后腹腔感染率为3.8%(12/314),实验组术后腹腔感染率明显下降,占0.39%(2/516),P<0.01,两组之间差异有显著性。结论"带蒂伞状胃壁"缝合在十二指肠残端表面,促进了十二指肠残端愈合,明显降低了术后十二指肠残端瘘、腹腔感染并发症发生率。

[Objective] To study the effect of preventing duodenum stump fistula used a stomach wall shaped like an umbrella linked with vessel.[Methods] 830 patients with bleeding in duodenal ulcer and gastric ulcer were divided into two groups.516 cases in treated group accepted stomach wall shaped like an umbrella linked with vessel buckle stitch to dodecadactylon after lacing the duodenum stump.314 cases in control group were covered with intestines series or pancreas tunica.To observe the complication after operat...