摘要
目的 观察胃、十二指肠溃疡穿孔行单纯缝合修补术后继以内科治疗的效果。方法 对168例胃、十二指肠溃疡穿孔患者行单纯修补术后 ,再行抗幽门螺杆菌等内科治疗 ,并跟踪随访观察。结果 本组 1年总复发率和胃、十二指肠溃疡复发率分别是 :术后正规内科治疗组为 5 .8% ,8.3 % ,3 .6% ;术后非正规内科治疗组 62 .9% ,66.7% ,5 8.8% ;术后未治疗组为 88.9% ,10 0 % ,80 .0 %。后 2组与正规治疗组间差异显著 (P <0 .0 5 )。术后采用正规内科治疗组 ,未出现出血、穿孔、幽门梗阻等并发症 ,无再手术者。出现并发症及再手术者 ,在非正规内科治疗组分别为 4.5 %和2 .4% ;在未接受内科治疗组为 42 .9%和 3 0 .0 %。吸烟者胃和十二指肠溃疡复发率分别为 80 .6%和 68.8% ,与不吸烟者差异有显著性 (P <0 .0 5 )。结论 溃疡穿孔单纯缝合修补操作简单、安全、并发症少 ,术后结合正规的内科治疗 ,效果满意。吸烟是影响溃疡愈合及复发的重要因素之一。
Objective To evaluate the effect of simple closure operation followed by anti-Helicobacter pylori(Hp)therapy for perforated peptic ulcer. Methods 168 cases of perforated peptic ulcer treated by simple closure operation with or without postoperative medication therapy were followed-up and analyzed. Results 1 year after operation, the recurrence rate of peptic ulcer was 3.8% in the group of standard anti-Hp therapy(S group), and that of gastric and duodenal ulcer in S group was 8.3% and 3.6%,respectively; while it was 62.9%, 66.7% and 58.8% in the group of non-standard Hp therapy (N-S group), and 88.9%, 100% and 80.0% in the group without Hp therapy (NT group).The diffcrence of reccurrence rate of peptic ulcer between S group with N-S group?NT group was significant(P<0.05). Complications including hemorrhage, perforation and pyloristenosis, which needed a re-operation, did not happen in the group of standard anti- Hp therapy; but developed in 4.5% and 2.4% of the patients with non-standard anti-Hp therapy, while they were 42.9% and 30.0% in the group without anti-Hp therapy respectively. The recurrences of gastric and duodenal ulcer in the smoking group were 80.6% and 68.8%, which were significantly higher than those in non-smoking group(P<0.05). Conclusions Simple suture for the perforated peptic ulcer is a simple and safe method with less complications. It promises a good prognosis for the patients who accept postoperative standard anti-Hp therapy. Smoking plays an important role in the ulcer recurrence.
出处
《中国普通外科杂志》
CAS
CSCD
2003年第7期486-489,共4页
China Journal of General Surgery
