溃疡病急性穿孔112例诊治分析

Analysis of 112 cases of diagnosis and treatment on peptic perforation

目的总结溃疡病急性穿孔的诊治经验,提高对溃疡病穿孔的诊治水平.方法对1990～2003年112例溃疡病急性穿孔患者的临床资料进行了回顾性分析.结果112例中术前确诊103例,误诊9例.单纯穿孔缝合58例,胃大部切除54例,均治愈或好转.结论术前X线和腹穿联合应用可提高溃疡病穿孔的确诊率.单纯穿孔缝合术与胃大部切除术近期疗效无显著差异,但远期疗效后者优于前者.

Objective: To summarize the experience of diagnosis and surgical treatment of perforation of peptic ulcer, and to improve the diagnosis and treatment. Methods: Retrospective analysis of the clinical data of 112 patients with perforation of peptic ulcer admitted to our hospital from 1990 to 2003. Results: Among the 112 cases, the diagnosis was made preoperatively in 103 cases, misdiagnosed in the other 9 cases. 58 cases underwent simple closure operation, and 54 cases underwent subtotal gastrectomy. All the patients were cured or got better. Conclusions: Combining use of X-ray with abdominocentesis examination can apparently improve the diagnosis rate. The early postoperative complications in simple closure operation group comparing with subtotal gastrectomy group are not significantly different, but the long-term effect of subtotal gastrectomy is much better than the promer.