胃大部切除术治疗急性胃溃疡穿孔37例临床观察

The clinical observation of 37 cases of stomach ulcer perforation undergoing emergent subtotal gastrectomy

目的探讨采用胃大部切除手术治疗胃溃疡急性穿孔方法及疗效。方法对1999～2010年收治的胃溃疡急性穿孔且采用胃大部分切除手术治疗的37例患者治疗资料及随访观察结果作以回顾总结。结果 37例患者手术均成功,无患者死亡,术后恢复至Ⅰ级者15例,至Ⅱ级者20例,至Ⅲ级者2例;平均(11.5±3.2)d后所有痊愈出院。37例患者共随访1～5年,其中1例患者在随访3年后出现吻合口溃疡,1例发生肠粘连,其余均未见远期并发症。结论胃大部切除手术能彻底解决溃疡及穿孔的问题,且死亡率低、远期复发率低,对符合适应证的急性胃溃疡穿孔患者可首选该手术治疗。

Objective To explore the method and effect of emergent subtotal gastrectomy on patients with stomach ulcer perforation. Methods The clinical data and follow - up results of 37 cases of stomach ulcer perforation undergoing emergent subtotal gastrectomy from 1999 ~ 2010 were analysed retrospectively. Results All 37 cases underwent emergent subtotal gastreetomy and recovered smoothly. The recovery reached grade I in 15 cases, grade Ⅱ in 20 cases, and grade Ⅲ in 2 cases. All the 37 cases were followed up for 1 -5 years, only 1 case had anastomosis leakage ulcer 3 years afert operation and 1 case had ankylenteren. Conclusion The treatment of emergent subtotal gastrectomy could resolve the ulcer and perforation with low death rate and complication rate. It should be considered as the first choice for patients with indication.