集束化治疗策略在胃十二指肠溃疡穿孔中的应用

Application of cluster therapy in perforation of gastroduodenal ulcer

目的探究集束化治疗策略在胃十二指肠溃疡穿孔中的应用效果。方法回顾性分析2018年1月至2019年12月柳城县人民医院普通外科收治的99例良性胃十二指肠溃疡穿孔患者的临床资料,2018年1—11月均采用常规治疗方式,共收集病例41例,作为常规组。2018年12月至2019年12月采用集束化治疗策略,共收集病例58例,作为集束化治疗组,均行腹腔镜下胃、十二指肠穿孔修补术。比较两组术前等待时间、手术时间、降钙素原、术中腹腔积液量、术后腹腔引流总量、并发症、住院时间、住院费用等。结果集束化治疗组术前等待时间、住院时间均短于常规诊疗组,术中腹腔积液量少于常规诊疗组,术前、术后降钙素原指标、并发症发生率、住院费用等均低于常规诊疗组,差异有统计学意义(P<0.05)。结论对急性胃十二指肠溃疡穿孔,采用集束化治疗策略,可明显缩短术前时间,减轻患者腹腔感染程度,促进术后康复,减少医疗费用。

Objective To explore application effect of cluster therapy in perforation of gastroduodenal ulcer.Methods From January 2018 to December 2019,99 patients with benign gastroduodenal ulcer perforation in the General Surgery of Liucheng County People’s Hospital were retrospectively analyzed.From January to November 2018,41 patients were treated with conventional treatment and selected as the conventional group,and from December 2018 to December 2019,58 patients were treated with cluster treatmentand selected as the cluster treatment group,and underwent laparoscopic repair of gastric and duodenal perforation.The waiting time before operation,operation time,procalcitonin,intraperitoneal effusion,total postoperative abdominal drainage,complications,length of stay,and hospitalization costs were compared between the two group.Results The waiting time before operation,length of stay in the cluster treatment group were shorter than those in the conventional group,and the volume of intraperitoneal effusion was less than that inthe cluster treatment group,the pre-and postoperative procalcitonin indexes,complications,and hospitalization costs were all lower than those in the cluster treatment group,the difference was statistically significant(P<0.05).Conclusion For acute gastroduodenal ulcer perforation,the use of bundled treatment strategy can significantly shorten the preoperative time,reduce the degree of abdominal infection in patients,promote postoperative recovery,and reduce medical costs.