三种术式治疗胃溃疡临床分析

CLINICAL EFFECTS OF THREE OPERATIVE METHODS FOR TREATMENT OF GASTRIC ULCERS

目的探讨三种不同手术方式治疗胃溃疡的临床意义和效果。方法选择2009年10月-2013年12月期间的81例胃溃疡患者,平均分为A、B、C三组,在切除远端胃部后,对A组患者进行BllrothⅠ式胃空肠吻合术,B组患者进行BllrothⅡ式胃空肠吻合术,C组患者进行Roux-en-Y胃空肠吻合术,观察三组患者的治疗效果以及并发症发生情况。结果 A、B、C三组患者治疗后总有效率均分别为100.0%、85.2%、88.9%,A组患者治疗效果最佳,但是三组患者治疗后总有效率比较差异无统计学意义（p〉0.05）,而A组患者中输入袢梗阻、吻合口溃疡、伤口感染的发生率均明显小于B、C两组,差异具有统计学意义（p〈0.05）,而C组患者的倾倒综合征的发生率明显低于A、B两组,差异具有统计学意义（p〈0.05）,同时B组患者的并发症发生率合计为44.4%,明显高于A、C两组,差异具有统计学意义（p〈0.05）。结论三种手术方法治疗胃溃疡患者的临床症状明显改善,均有较高的临床效果,其中BllrothⅠ式胃空肠吻合术疗效最佳,并发症最少,值得临床推广。

Objective To investigate the clinical effects of three different operative methods in the treatment of gastric ulcers. Methods 81 patients with gastric ulcers admitted during October 2009 to December 2013 were selected and divided into A,B,C groups. After resection of the distal stomach,the patients in Group A were given Bllroth I type gastrojejunostomy,the patients in Group B Bllroth II type gastrojejunostomy,and group C Roux- en- Y gastric bypass surgery. Curative effects and complications were then observed and compared among the groups. Results The total effective rates of Group A,B,C were 100%,85. 2%,88. 9% respectively,but the total efficiency difference among the three groups was not statistically significant（ p〈0. 05）,however,the rates of input loop obstruction,anastomotic ulcer and wound infections of Group A were significantly smaller than of Groups B and C（ P〉 0. 05）,whereas the incidence of dumping syndrome patients in Group C was significantly significantly lower than Group A and B（ P 〈0. 05）. The incidence of complications in Group B was 44. 4%,significantly higher than Group A and C（ p〈0. 05）. Conclusion The clinical symptoms of three operative methods for the treatment of gastric ulcer patients are improved obviously. The clinical effects are greater. Bllroth I type gastrojejunostomy has the best curative effect and the least complications,and therefore is worth the clinical promotion.