老年胃十二指肠穿孔行开腹修补术和胃大部切除术治疗的临床分析

Clinical analysis of open repair and subtotal mastrectomy treatment in elderly gastroduodenal perforatio

目的探讨单纯开腹修补术和胃大部切除术对老年胃十二指肠穿孔的治疗效果。方法60例老年胃十二指肠穿孔患者随机分为两组,每组30例,一组进行单纯开腹修补术治疗为开腹修补术组,一组进行胃大部切除术治疗为胃大部切除术组,对比两组治疗方式的手术有效例数、无效例数、手术成功率以及并发症的发生情况,分别记录两种治疗方式的平均手术时间、住院时间、胃肠功能恢复时间以及复发的情况。结果单纯开腹修补术和胃大部切除术的手术成功率差异无统计学意义(P>0.05),但单纯开腹修补术所导致的并发症发生率比胃大部切除术的低,同时在平均手术时间、住院时间和胃肠功能恢复时间方面,开腹修补术明显比胃大部切除术的时间短,但复发率却明显高。结论单纯开腹修补术与胃大部切除术治疗老年胃十二指肠穿孔都有很高的成功率,开腹修补术具有手术时间短、并发症少和恢复速度快等特点,但是复发率稍高,而胃大部切除术治疗后的复发率稍低,但造成的创伤较大,所以对老年胃十二指肠穿孔患者应选择合适的手术方式进行治疗。

Objective To explore effect between open repair and subtotal mastectomy in elderly gastroduodenal perforation. Methods Divided 60 elderly patients with gastroduodenal perforation into open repair group and subtotal mastectomy group, 30 cases in each group, open repair group was performed open repair treatment, subtotal mastectomy group was performed subtotal mastectomy treatment, effective number, invalid number, surgical success rate and complications of two groups were compared. Results Surgical success rate in two groups was no statistical significance（P〉0.05）, but complications caused by open repair treatment were lower than subtotal mastectomy, while in the mean operative time, hospital stay and recovery time of gastrointestinal function in open repair treatment were shorter than subtotal mastectomy, but the recurrence rate was significantly higher. Conclusion Simply open repair or subtotal mastectomy has a high successful rate in the treatment of elderly gastroduodenal perforation. Open repair with shorter operative time, fewer complications and faster recovery characteristics, but relapse rate is a bit high, while most of subtotal mastectomy with a lower recurrence rate after treatment, but with a larger trauma, so elderly patients with gastroduodenal perforation should select the appropriate surgical treatment.