单纯修补治疗十二指肠溃疡穿孔65例临床分析

The clinical analysis of 65 cases of perforated duodenal ulcer by the treatment of simple closure

目的 观察单纯修补术治疗十二指肠溃疡穿孔的长期疗效以及腹腔镜下穿孔修补的效果。方法 采用在腹腔镜下或开腹单纯修补术治疗十二指肠溃疡穿孔病人 65例。术后口服兰索拉唑 ,阿莫西林及呋喃唑酮 1周 ,随访 3～ 31个月。结果 疗程结束后 1个月溃疡愈合率为 96.9% ,术后 1年、2年复发率分别为 4.2 %及 5 .9%。全组无因溃疡复发而再手术病例。开腹组与腹腔镜组住院天数存在极显著性差异。结论 溃疡穿孔单纯修补术简单安全 ,配合术后药物治疗 ,疗效满意 ,尤其是腹腔镜下溃疡修补术 。

Objective Observe the effect of simple closure for the treatment of perforated duodenal ulcers and the efficacy of laparoscopic repair in the condition of modern medical treatment.Methods 65 cases with duodenal ulcer perforation were operated on simple closure with open or laparoscopy.All patients were received triple therapy of lansoprasole 30 mg qd+am oxycillin 1g bid+furazolidone 0.1 g tid for a week and were followed up for 3～31 months.Results The ulcer cure rate was 96.9% after the triple therapy had been finished for one month.Postoperatevely,the ulcer recurrence rates within one and two years were 4.2% and 5.9%.No one was reoperated because of ulcer recurrence.The length of hospital stay had a very significant difference between open operation group and laparoscopy group.Conclusion The operation of simple closure,especially laparoscopic repair is simple and safe,and should has a priority to treat perforated duodenal ulcers.