胃十二指肠溃疡穿孔276例临床分析

Analysis of 276 cases with perforated gastric or duodenal ulcer

目的探讨胃十二指肠溃疡穿孔的诊断、治疗、预后。方法对1993年1月至2003年1月经治的276例胃十二指肠溃疡穿孔的临床资料进行回顾性分析。结果胃溃疡穿孔66例,膈下游离气体54例,死亡3例。十二指肠溃疡穿孔210例,膈下游离气体144例,死亡2例。结论胃溃疡穿孔膈下游离气体的发生率较十二指肠溃疡穿孔高,死亡率也较高。早期诊断、合理的术式选择是提高治愈率,减少术后并发症,降低死亡率的关键。

Objective To explore diagnosis, treatment and prognosis of perforated gastric or duodenal ulcer. Methods The clinical data of 276 patients with perforated gastric or duodenal ulcer were analyzed retrospectively from January 1993 to January 2003. Results There were 54 cases with free gas between the diaphram and the upper surface of the liver among 66 cases with perforated gastric ulcer and three cases died, and 144 cases among 210 cases with perforated duodenal ulcer and two cases died. ConcluSion Tbe morbidity of free gas between the diaphram and the upper surface of the liver in the perforated gastric ulcer is higher than that in the perforated duodenal ulcer. The mortality was higher in the former than that in the latter. The key to raise the cure rate, diminish the complication after operation and diminish the mortality is to diagnosis in early stage and elect suitable operation.