上消化道溃疡穿孔85例诊治及护理分析

Diagnosis and Treatment and Nursing of 85 Cases Suffered from Perforated Ulcer of Upper Digestive Tract

目的 探讨上消化道溃疡穿孔的临床诊断、治疗及护理。方法 对８５ 例上消化道穿孔诊断及手术治疗、护理做回顾性分析。结果 腹疼、腹膜炎体征、腹部定位Ｘ线检查和腹穿是诊断主要依据。单纯缝合修补术后３ 个月、２ 年、５ 年溃疡复发率分别１１ ％ （７／６５） 、２０ ％ （９／４８） 、２５ ％ （５／２０） ，与高选迷切加缝补相比， 无显著差异（ Ｐ＞ ０．０５） ，远期并发症发生率为８ ％ （５／６５） ，亦低于后者（ Ｐ＜ ０ ．０５）。结论 上消化道穿孔单纯修补操作简单，安全，并发症少，术后结合正规内科治疗，效果满意。

Objective To study the diagnosis,treatment and nursing of perforated ulcer of upper digestive tract. Methods Diagnosis, operation treatment and nursing to 85 cases suffered from hemorrhage of upper digestive tract were analysed retrospectively.Results Abdominal pain,peritonitis,ventral spine and X-ray examination were main diagnosis basis.Recurrence rate of ulcer was 11% after three months of simple prosthesis,two years later 20%, and five years later 25%, and the curative effect of simple prothesis had no great difference from that of superselective vagotomy,(P>0. 05),the recurrence rate 8% of complications of simple prothesis is less than those of superselective ragotomy(P<0.05).Conclusion Operation of simple prothesis is simple and safe, and its complications are less, its curative effect combined with medical treatment after operation is satisfactory.