急性胃穿孔行两种不同术式的疗效比较

Comparison of Two Different Surgical Methods for the Treatment of Acute Gastric Perforation

目的分析两种不同手术方式治疗急性胃穿孔的疗效。方法回顾性分析本院2013年2月至2015年7月收治的60例急性胃穿孔患者的资料,按治疗方式不同分为A组(胃大部分切除术)和B组(单纯修补术),每组30例,观察两组术中指标(手术时间、术中出血量)、术后指标(首次排气时间、住院天数、首次下床活动时间)以及并发症发生率、术后随访12个月复发率情况。结果 B组术中指标(手术时间、术中出血量)、术后指标(首次排气时间、住院天数、首次下床活动时间)以及并发症发生率均显著少于与A组,但术后12个月回访其复发率显著高于A组(P<0.05)。结论单纯修补术和胃大部分切除术在急性胃穿孔患者手术治疗中各有所长,应用时需要根据患者的实际情况进行选择。

Objective To analyze the curative effects of two different surgical methods for the treatment of acute gastric perforation. Methods The clinical data of 60 cases of patients with acute gastric perforation in our hospital from February 2013 to July 2015 were analyzed retrospectively. According to the surgical methods, all cases were divided into group A （subtotal resection of stomach） and group B （simple repair operation）, with 30 cases in each group. The surgical indicators （operation time, intraoperative blood loss） and postoperative indicators （first exhaust time, length ＆hospital stay, the time to get out of bed） of two groups were observed. All cases were followed up for 12 months, and the incidence of complications and recurrence rate were observed. Results The surgical indicators （operation time, intraoperative blood loss）, postoperative indicators （first exhaust time, length of hospital stay, the time to get out of bed）, and incidence of complications at 12 months after surgery of group B were significantly better than those ＆control group （P〈0.05）, while the recurrence rate at 12 months after surgery of group B was significantly higher than that of group A （P 〈0.05）. Conclusions Both subtotal resection of stomach and simple repair operation have advantages and disadvantages for the treatment of acute gastric perforation, and they need to be selected according to the actual situation of the patient.