62例老年急性胃十二指肠穿孔临床分析

Clinical analysis of 62 old-patients with acute perforated gastroduodenal ulcers

目的探讨老年急性胃十二指肠穿孔患者的临床特点和治疗措施,为老年急性胃十二指肠穿孔临床诊治提供依据。方法回顾性分析武昌医院从2010年2月～2011年8月收治的62例老年急性胃十二指肠穿孔患者的临床资料。结果 62例患者中20例患者进行保守治疗,治愈率为70.00%,42例患者进行手术治疗,治愈率为92.86%,保守治疗的临床疗效明显低于手术治疗。42例手术患者中有12例出现术后并发症,发生率为28.57%。结论老年急性胃十二指肠穿孔患者临床特征不典型,易误诊,并发疾病和术后并发症多,病死率较高。早期正确诊断十分重要,手术治疗是主要治疗方法,保守治疗过程中要严密观察患者病情,预防并发症发生,提高治愈率。

Objective To investigate the clinical features and treatment of the acute perforated gastroduodenal ulcer and in order to provide clinical ground for old-patients with Acute perforated gastroduodenal ulcers. Methods A retrospective analysis was performed based on the clinical features and treatment of 62 old-patients with acute perforated gastroduodenal ulcers treated at our hospital between February 2010 and August 2011. Results 42 cases were treated by surgical operation,and the curative ratio was 92.86%.20 cases were treated by conservative treatment,and the curative ratio was 70%.The clinical therapeuticeffect of surgical operation was better than conservative treatment. 12 cases developed complications after the surgery,and the rate of complications was 28.57%（12/42）. Conclusion The clinical manifestations of old-patients with acute perforated gastroduodenal ulcers are variety and non-typical, misdiagnosis and post-surgical operation complications most easily occurs. Early correct diagnosis is very important.Surgical operation is the major treatment of old-patients with acute perforated gastroduodenal ulcer. In the course of the conservative treatment, close observation and prevention from complication can imtprove the cure rata.