【摘要】 目的　探讨消化性溃疡穿孔保守治疗的定量指标。方法　回顾性分析 1 990～ 1 999年收治的溃疡病穿孔 32 1例的临床资料 ,按腹痛范围 ,是否空腹 ,腹穿情况 ,穿孔时间 ,年龄 ,发热 ,腹腔游离气体评分。结果　保守治疗 2分以内 85例 ,治愈 81例 (95 .2 % ) ;3分 2 2例 ,治愈 1 6例 (72 .7% ) ;4分 8例 ,治愈 2例 (2 5 .0 % )。差异有显著性 (P <0 .0 5 )。结论　对≤ 2分病例应争取保守治疗 ,3分病例可先行保守治疗 2 4h ,如病情好转 ,可继续保守治疗 ,病情加重应及时中转手术。≥ 4分病人不宜保守治疗 ,宜及早手术更多还原

【Abstract】 Objective To determine the quantitative indices of conservative treatment for perforation of peptic ulcer. Methods The clinical data of 321 patients admitted from 1990 to1999 were analyzed retrospectively. Score was obtained according to patients’ age, extension of abdominal pain, time of perforation, fever,abdominal paracentisis,free air of abdominal cavity, etc.Results Conservative treatment was given to 85 patients who scored ≤ 2, of whom 81 (95.2%) recovered.In 22 patients who scored 3, 16 (72.7%) recovered.In 8 patients who scored 4, 2 (25.0%) recovered.Conclusions If the perforating ulcer patients scored less than 2, conservative treatment should be given.For those who scored 3, conservative treatment can be given for the first 24h,and then whether to continue conservative treatment or change to operation should be considered according to patients’ condition.For patients scored ≥ 4 , an operation should be performed as soon as possible.更多还原