非手术与手术治疗穿孔性十二指肠溃疡的比较

目的 :比较非手术与手术治疗穿孔性十二指肠溃疡的疗效。方法 :对我院 1995年 1月至 1999年 12月期间 ,所收治的 2 5 4例穿孔性十二指肠溃疡病人的临床资料进行回顾分析。结果 :非手术治 5 8例 ,1例出现腹腔脓肿 ,无一例再穿孔和死亡 ,3个月后溃疡愈合率为 92 .5 % ;手术治疗 186例 ,其中 10 2例行穿孔修补术 ,无一例出现腹腔脓肿 ,1例出现幽门梗阻需再行胃大切术 ,3个月后溃疡愈合 94 .1% ,与非手术治疗无明显差异 ,另外 84例行胃大部分切除术 ,出现残端漏 2例 ,腹腔脓肿 1例。结论 :急性十二指肠溃疡穿孔能自行闭合 ,以非手术治疗史合理和安全 ,通过使用抗生素、质子泵抑制剂或H2 受体阻止剂联合药物治疗 ,溃疡是可治愈的。不能自行闭合的急性穿孔 ,选择单纯修补可降低手术并发症 ,术后配合内科治疗也可达到溃疡治愈目的。慢性十二指肠溃疡穿孔 ,往往伴有溃疡周围疤痕多、胼胝状溃疡、幽门梗阻、病史长、症状严重反复发作等因素 ,即使穿孔超过 12h ,仍可以选择“溃疡确定性外科”治疗。

Clinical Research on Zishengukang Pill(滋肾骨康丸)Used to Treat Delayed Union of Fracture

Objective:To observe the curative effect of Zishengukang Pill(滋肾骨康丸) on delayed union of fracture.Methods:Sixty-four patients with delayed union of fracture were randomly divided into a control group of 32 cases treated with Western medicine and a treatment group of 32 cases treated with Western medicine and Zishengukang Pill.After 3 courses of treatment with 30 days as a course,the curative effects in the two groups were evaluated and their clinical symptoms,union rate and union time of fracture were compared.Results:The treatment resulted in cure in 25 cases,improvement in 6 cases and ineffectiveness in 1 case with the effective rate at 96.8% in the treatment group,higher than 81.3% in the control group(P<0.05).The union rate of fracture in the treatment group was higher than that in the control group(34.3% vs.12.5%,P<0.05).The union time of fracture in the treatment group was shorter than that in the control group((4.0±1.7) months vs.(5.0±1.4) months,P<0.05).Conclusion:Zishengukang Pill with obvious curative effect in the treatment of delayed union of fracture is worth popularizing.