胃穿孔行修補(bǔ)術(shù)和胃大部切除術(shù)的研究

　　摘   要：目的  研究胃穿孔行修補(bǔ)術(shù)和胃大部切除術(shù)的臨床療效。方法  回顧分析2016年10月～2017年10月在我院治療的90例胃穿孔患者臨床資料，依據(jù)手術(shù)方法將其分為修補(bǔ)組和切除組，各45例。切除組采用胃大部切除術(shù)，修補(bǔ)組采用修補(bǔ)術(shù)，對(duì)比兩組患者臨床療效。結(jié)果  修補(bǔ)組治療總有效率與切除組對(duì)比，差異無統(tǒng)計(jì)學(xué)意義（P>0.05）;修補(bǔ)組手術(shù)時(shí)間、住院時(shí)間短于切除組，術(shù)中出血量少于切除組，并發(fā)癥發(fā)生率低于切除組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）;切除組復(fù)發(fā)率低于修補(bǔ)組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論  胃修補(bǔ)術(shù)和胃大部切除術(shù)治療胃穿孔均具有一定的療效，修補(bǔ)術(shù)創(chuàng)傷小，手術(shù)時(shí)間短，出血量少，而切除術(shù)復(fù)發(fā)率低。兩種手術(shù)方法各有優(yōu)勢(shì)，臨床應(yīng)依據(jù)患者具體情況合理選擇。
　　關(guān)鍵詞：胃穿孔;修補(bǔ)術(shù);胃大部切除術(shù)
　　中圖分類號(hào)：R656.61                                 文獻(xiàn)標(biāo)識(shí)碼：A                               DOI：10.3969/j.issn.1006-1959.2018.05.034文章編號(hào)：1006-1959（2018）05-0103-02
　　Repair of Gastric Perforation and Subtotal Gastrectomy
　　ZHOU Jun
　�。―epartment of General Surgery，Zhongzang Hospital，Jiuzhaigou 623400，Sichuan，China）
　　Abstract：Objective  To study the clinical effect of repair and subtotal gastrectomy for gastric perforation.Methods  The clinical data of 90 patients with gastric perforation treated in our hospital from October 2016 to October 2017 were retrospectively analyzed. According to the operative method，the patients were divided into two groups：the repair group and the resected group，45 cases each group.The resection group was treated with subtotal gastrectomy，and the repair group with the repair operation.Comparison of clinical efficacy between the two groups was made.Results  There was no significant difference in the total effective rate between the repair group and the resection group（P>0.05），the operative time，the hospitalization time and the amount of intraoperative bleeding in the repair group were shorter than those in the resection group，and the incidence of complications was lower than that in the resection group，the difference was statistically significant（P<0.05）.The recurrence rate in resection group was lower than that in repair group，the difference was statistically significant（P<0.05）.Conclusion  Gastric repair and subtotal gastrectomy are effective in the treatment of gastric perforation.They have advantages of less trauma，shorter operation time，less bleeding，and lower recurrence rate of resection. Clinical selection should be based on the patient"s specific situation.
　　Key words：Gastric perforation;Repair;Subtotal gastrectomy
　　胃穿孔（gastric perforation）是胃潰瘍常見的多發(fā)并發(fā)癥，通常發(fā)病急，病情進(jìn)展快，臨床表現(xiàn)為穿孔部位或上腹部灼燒、似刀割劇烈疼痛，嚴(yán)重時(shí)會(huì)發(fā)生腹膜炎，造成死亡[1，2]。臨床如果不及時(shí)有效治療，會(huì)危及患者的生命安全。隨著手術(shù)方式的多樣化，選擇合理的手術(shù)方式成為治療的關(guān)鍵。臨床中單純修補(bǔ)術(shù)和胃大部切除術(shù)是主流的術(shù)式選擇，但是兩者的臨床療效和安全性備受爭(zhēng)議[3]。本文結(jié)合我院治療的90例胃穿孔患者臨床資料，研究胃穿孔行修補(bǔ)術(shù)和胃大部切除術(shù)臨床效果，現(xiàn)報(bào)告如下。

相關(guān)熱詞搜索：胃穿孔 大部 切除術(shù) 研究 修補(bǔ)術(shù)