【摘要】 目的研究十二指肠溃疡穿孔的两种不同疗法——穿孔修补术加近侧胃迷走神经切断术（ＰＧＶ）与穿孔修补术加奥美拉唑方案的临床疗效。方法将１９９４年１月－１９９６年１２月相继入院的４８例十二指肠溃疡穿孔患者随机分为Ａ、Ｂ两组。Ａ组（２１例）在穿孔修补术的基础上，加行ＰＧＶ。Ｂ组（２７例）仅作穿孔修补术，术后辅予奥美拉唑方案（即口服奥美拉唑加羟氨苄青霉素加灭滴灵）。术后定期随访。随访结果按Ｖｉｓｉｃｋ标准分级。结果Ａ组术后半年和２年疗效优良者（ＶｉｓｉｃｋⅠ加Ⅱ级）分别为１８例（８５．７％）和１７例（８１．０％），溃疡复发者（ＶｉｓｉｃｋⅣ级）分别为１例（４．８％半年）和２例（９．５％２年）。Ｂ组术后半年和２年疗效优良者分别为１９例（６６．７％）和１０例（３７．０％），溃疡复发者分别为５例（１８．５％）和１２例（４４．５％）。Ａ组疗效优于Ｂ组（Ｐ＜０．０１）。Ｈｐ检测，Ａ组术后半年和两年的Ｈｐ阳性率分别为８１．０％和８５．７％（Ｐ＞０．０５）；Ｂ组分别为１８．５％和５１．９％（Ｐ＜０．０１）。结论十二指肠溃疡穿孔在施行修补术后，应同时加行ＰＧＶ，以提高对溃疡病的根治效果更多还原

【Abstract】 Objective To Study the curative effects of suture plus PGV and suture plus omeprazole plan for the treatment of duodenal ulcer with acute perforation. Method 48 patients with duodenal ulcer and acute perforation admitted from Jannary, 1994 to December, 1996 were randomized into two groups. The patients in group A (21 cases) were treated with SPP, and the patients in group B (27 cases) with SPO. Postoperative clinical symptoms, endoscopic appearance and detecting for Helicobacter pylori (Hp) were evaluated. Results The curative effect of group A at the time of half years and two years postoperation were 18(85 7%) and 17(81 0%) cases (visick Ⅰ,Ⅱ), respectively. The group B’s curative effect were 19(66 7%) and 10(37 0%) respectively at time of half years and two years postoperation. In detecting for Hp, there were 17(81.0%) and 18(85.7%) in gorup A ( P >0.05),and 5 (18.5%) and 14(51.9%) in group B ( P <0.01) being positive at the time of postoperative six and 24 months respectively. Conclusion Suture plus PGV should be selected for the treatment of duodenal ulcer with acute perforation to improve the radical cure of the disease.更多还原