【摘要】 目的总结胃大部切除术治疗消化性溃疡急性穿孔的临床经验,旨在提高该病Ⅰ期手术治愈的成功率。方法回顾性分析208例消化性溃疡急性穿孔的临床资料,其中86例(41.35%)采用胃大部连同病灶切除,Ⅰ期治愈;胃肠重建采用BillrothⅠ式吻合18例(20.93%),BillrothⅡ式吻合68例(79.07%),其中BillrothⅡ式结肠前吻合42例(61.76%),结肠后吻合26例(38.24%)。结果86例中,1例BillrothⅡ式吻合术后发生胃瘫,经保守治疗月余治愈,其余病例术后恢复均顺利,随访5年以上预后良好。结论消化性溃疡急性穿孔Ⅰ期行胃大部切除术治疗,既解决了穿孔单纯修补术后再次复发穿孔、出血、幽门梗阻、粘连、溃疡恶变等问题,又缩短了治愈周期,提高了生存质量。更多还原

【Abstract】 Objective To summarize the clinical experience of subtotal gastrectomy for acute perforation of peptic ulcer.Methods Data of 208 cases of acute perforation of peptic ulcer were analysed retrospectively.Among the 208 cases,86 cases(41.35%) achieved one-stage recovery by subtotal gastrectomy including focus removal;thereinto,18 cases(20.93%) were undergone Billroth I anastomosis,68 cases(79.07%) Billroth Ⅱ,42 cases(61.76%) Billroth Ⅱ precolonic anastomosis,26 cases(38.24%) retrocolonic anastomosis.Results After operation,all the cases recovered in good condition with 5-year following up,except one complication of gastroparesis.Conclusion The procedure not only can resolve the problems of perforation relapse,ulcer bleeding,pylorus obstruction,ulcer carcinogenesis,but also can shorten the recovery time and increase life quality.更多还原