非手术治疗胃十二指肠溃疡急性穿孔38例诊治分析

Nonoperative Treatment Stomach Duodenal Ulcer Acute Perforation 38 Cases of the Experience of Diagnosis

目的:探讨保守治疗在胃十二指肠溃疡急性穿孔治疗中的价值。方法:通过禁食水,持续胃肠减压、纠正水电解质酸碱平衡紊乱、静脉高营养及抗感染抑酸等非手术治疗情况,分析疗效。结果:患者为空腹穿孔,腹腔穿刺腹腔渗液不能抽出或较难抽出且少于5ml,住院时急性症状已缓解,无幽门梗阻及出血史,无感染性休克,可以行非手术治疗,疗效与手术治疗相比,无显著差异。结论:掌握胃十二指肠溃疡急性穿孔的非手术治疗的适应证,达到治疗效果的同时,不增加并发症发生率和死亡率,若需手术或内科治疗无效时必须及时实施手术,以达到预期疗效。

Objective：Explore the conservative treatment in gastric ulcer acute perforation in the therapy of value.Methods： By forbid food and water,continuous gastrointestinal decompression,correction fluid and electrolyte acid-base balance disorders,intravenous nutrition and antibiotics with high acid-suppressing other non-surgical treatment,analyze the effect.Results： The patients were limosis perforation,abdominal paracentesis and peritoneal exudate can not devote or difficult to extract and less than 5ml,the acute symptoms of them has been relieved when hospitalized,they are with no history of pyloric obstruction and bleeding,non-septic shock,and can receive line non-surgical treatment,the efficacy and compared to surgical treatment,no significant difference.Conclusion： To master the adaptation of non-surgical treatment to acute perforated gastroduodenal ulcer patients,while to achieve the treatment effect at the same time not increase morbidity and mortality,if the patient need surgical or medical treatment fails should timely implementation of the operation in order to achieve expected effect.