胃大部分切除术与单纯修补术治疗急性胃穿孔的临床疗效比较

Curative effect comparison of subtotal gastrectomy and stomach simply neoplasty on acute gastric perforation

目的探讨胃大部分切除术与单纯修补术治疗急性胃穿孔的临床疗效。方法将在我院进行手术治疗的46例急性胃穿孔患者临床资料进行回顾性分析,选取时间为2011年1月至2016年1月,根据患者的手术方式将其分为对照组(23例)实施胃大部分切除术和观察组(23例)实施单纯修补术。对两组患者的手术时间、下床时间、肛门排气时间、住院时间、治疗总有效率、并发症发生率及复发率进行比较分析。结果观察组治疗总有效率达到95.65%,明显高于对照组的73.91%(P<0.05)。经治疗,观察组患者的手术时间、下床时间、肛门排气时间及住院时间均短于对照组(P<0.05)。观察组患者术后伤口感染、残端瘘、吻合口梗阻及胃瘫的发生率与对照组比较,无显著差异(P>0.05);术后随访1年,观察组患者的术后复发率稍高于对照组,但差异没有统计学意义(P>0.05)。结论与胃大部分切除术相比,单纯修补术治疗急性胃穿孔可大大地降低手术对患者的损伤,提高其预后水平,且术后出现并发症与复发的情况较少。

Objective To investigate the effect of subtotal gastrectomy and stomach simply neoplasty on acute gastric perforation. Methods From January 2011 to January 2016, the clinical data of 46 cases of patients with acute gastric perforation underwent operation in our hospital were retrospectively analyzed, all the patients were divided into control group （23 cases） received subtotal gastreetomy and observation group （23 cases） accepted stomach simply neoplasty according to the operation methods. The operative time, getting out of bed time, expiratory drainage time, hospitalization time, the total effective rate of treatment, the incidence of complications and the recurrence were compared and analyzed in the two groups. Results The total effective rate of the observation group was 95.65%, which was significantly higher than 73.91% of the control group （P〈0.05）. After treatment, the operative time, getting out of bed time, expiratory drainage time, hospitalization time in the observation group were shorter than those of the control group （P〈0.05）. There were no significant differences in the incidence of wound infection, stump fistula, anastomotic obstruction and gastroparesis between the observation group and the control group （P〉0.05）. Followed up for 1 year after operation, the recurrence rate of the observation group was slightly higher than that of the control group, but the difference was not statistically significant （P〉0.05）. Conclusion Compared with subtotal gastrectomy, the stomach simply neoplasty can reduce the surgery injury for patients with acute gastric perforation, improve the prognosis, with less postoperative complications and recurrence.